View optimizer and stabilizer for use with surgical scopes

ABSTRACT

The present application discloses several devices for maintaining visualization with a surgical scope. The embodiments of the device are adapted to shield, defog or clean the lens of the surgical scope while the surgical scope is being used to perform a surgical procedure within a patient&#39;s body. In some embodiments, the view optimizer is provided in multiple parts enabling separation of one or more operator control features from engagement with the surgical scope. In some embodiments, the view optimizer features stabilization means for securement and positioning with the surgical scope.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is related to U.S. Utility application Ser. No.11/765,340, filed Jun. 19, 2007 and to PCT Application Serial No.PCT/US2008/067426, filed Jun. 19, 2008, the entirety of whichapplications are incorporated by reference herein.

PRIORITY CLAIM

This application claims priority to U.S. Provisional Application Ser.Nos. 61/121,514 filed on Dec. 10, 2008 and 61/170,864 filed on Apr. 20,2009, the entirety of which applications are incorporated by referenceherein.

TECHNICAL FIELD

The present application relates generally to various embodiments of adevice for maintaining visualization with surgical scopes. Moreparticularly, this application relates to various embodiments of a viewoptimizer adapted to shield, clean and defog or clean the lens of asurgical scope, such as a laparoscope, while the surgical scope is beingused to perform a surgical procedure within a cavity of a patient'sbody.

BACKGROUND OF THE INVENTION

Minimally invasive surgical procedures utilizing surgical scopes aredesirable because they often provide one or more of the followingadvantages: reduced blood loss; reduced post-operative patientdiscomfort; shortened recovery and hospitalization time; smallerincisions; and reduced exposure of internal organs to possiblecontaminants.

Generally, minimally invasive surgeries utilize scopes, such aslaparoscopes, that permit remote visualization of a surgical site withina patient's body while the surgical procedure is being performed. Duringa laparoscopic procedure, the patient's abdominal or pelvic cavity isaccessed through two or more relatively small incisions rather thanthrough a single large incision that is typical in a conventionalsurgery. Surgical scopes, such as laparoscopes, usually consist in partof a rigid or relatively rigid rod or shaft having an objective lens atone end and an eyepiece and/or integrated visual display at the other.The scope may also be connected to a remote visual display device or avideo camera to record surgical procedures.

In laparoscopic surgeries, the abdomen is typically inflated with a gasthrough the use of an insufflator, to distend the abdominal space byelevating the abdominal wall above the internal organs and therebycreate a sufficient working and viewing space for the surgeon. Carbondioxide is usually used for insufflation, though other suitable gasesmay also be used. Conventional insufflators are adapted to cycle on andoff to maintain a preset and suitable pressure within the patient's bodycavity.

The local environment within a patient's abdominal space is generallyrather warm and humid, and the use of devices such as harmonic scalpelsand other cutting and coagulating devices generate mist, smoke, andother debris that is released into the surgical field and often becomessuspended throughout the expanded abdominal space. Additionally, blood,bodily fluids, pieces of tissue, fat or other bodily material may comein contact with or even attach to the lens. As a result of theseconditions, visualization through the scope can be significantlydiminished. Typically, the only solution to fogging and debriscollection on the lens is removal of the scope from the body cavity anddefogging or cleaning the lens by wiping it with a cloth, warming thescope tip, or utilizing another defogging method. The need to remove thescope to defog and remove debris from the lens is inconvenient for thescope operator and the surgeon and can interrupt and undesirably prolongsurgical procedures.

SUMMARY

Embodiments of a device for maintaining visualization with a surgicalscope are provided. The embodiments of the device are adapted to shield,defog or clean the lens of the surgical scope while the surgical scopeis being used to perform a surgical procedure within a patient's body.Some embodiments include features for stabilizing the scope and itsposition relative to the view optimizer and for locking the viewoptimizer to a surgical scope.

Additional features and advantages of the invention will be set forth inpart in the description which follows, and in part will be obvious fromthe description, or may be learned by practice of the invention. Thefeatures and advantages of the invention will be realized and attainedby means of the elements and combinations particularly pointed outherein.

It is to be understood that both the foregoing general description andthe following detailed description are exemplary and explanatory onlyand are not restrictive of the invention.

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate several embodiments of theinvention, and together with the description, serve to explain theprinciples of the invention.

BRIEF DESCRIPTION OF THE DRAWINGS

The present invention may be more readily understood by reference to thefollowing drawings wherein:

FIG. 1A is a perspective view of a laparoscope;

FIG. 1B is a perspective view of a trocar;

FIG. 2A is a perspective view of an exemplary embodiment of the viewoptimizer showing the lens guard and flow controller as separate partsinterconnected with tubing;

FIG. 2B shows a perspective view of another exemplary embodiment of theview optimizer showing the lens guard and the flow controller withintegrated construction;

FIG. 2C is a photograph of yet another exemplary embodiment of the viewoptimizer showing the lens guard and flow controller as separate partswhich are interconnected with tubing, where with the lens guard isengaged with a conventional laparoscope and is connected via tubing withthe flow controller and the flow controller is connected to additionaltubing for interconnection with sources of saline and CO₂ and aconventional insufflator trocar;

FIG. 3A shows in four panels exploded perspective views of the flowcontroller and the lens guard of the view optimizer of FIG. 2C;

FIG. 3B shows an exploded perspective view of the view optimizer of FIG.2B;

FIG. 4A shows a magnified perspective view of the guard tube of the lensguard of a view optimizer with a conventional laparoscope insertedtherethrough;

FIG. 4B shows a magnified perspective view of the guard tube and exhaustring of the lens guard of a view optimizer;

FIG. 4C shows a magnified perspective view of the guard tube, exhaustring and end ring of the lens guard of a view optimizer;

FIG. 4D shows a magnified perspective view of a guard tube and exhaustring of the lens guard of the view optimizer of FIG. 3A adapted for usewith a surgical scope having a 0° tip;

FIG. 4E shows a magnified perspective view of a guard tube and exhaustring of the lens guard of the view optimizer of FIG. 3A adapted for usewith a surgical scope having a 30° tip;

FIG. 4F shows a magnified perspective view of a guard tube and exhaustring of the lens guard of the view optimizer of FIG. 3A adapted for usewith a surgical scope having a 45° tip;

FIGS. 4G, 4H and 4I show a front perspective, rear plan and rearperspective views of an embodiment of the lens guard exhaust ring;

FIG. 4J shows an alternate side view of the lens guard depicted in FIG.2C and FIG. 4K;

FIG. 4K shows a side perspective view of the lens guard depicted in FIG.2C upper panel;

FIG. 5A shows a magnified front perspective view of the adapter ring ofthe lens guard of the view optimizer of FIG. 2B;

FIG. 5B shows a magnified rear perspective view of the adapter ring ofthe lens guard of the view optimizer of FIG. 2B;

FIG. 6 shows an alternate perspective view of the view optimizer of FIG.2B;

FIG. 7 shows results of analysis of humidity and fogging; and

FIG. 8 shows results of evaluation of effect of introduction ofcompliant accumulator on flow across laparoscope lens;

FIG. 9A shows an perspective view of the lens guard of the viewoptimizer of FIG. 2C and FIG. 3A;

FIG. 9B and FIG. 9B′ show an exploded perspective view of the lens guardof the view optimizer of FIG. 2C and FIG. 3A;

FIG. 9C shows a magnified perspective view of the tip and exhaust ringof the guard tube of the lens guard of the view optimizer of FIG. 2C andFIG. 3A;

FIG. 10 shows alternate perspective views of the flow controller of theview optimizer of FIG. 2C and FIG. 3A and a cutaway view of the flowcontroller of the view optimizer of FIG. 2C, detailing the mechanismsfor actuation of liquid flow and bolus flow of FIG. 2C and FIG. 3A;

FIG. 11 shows a schematic of an embodiment of the view optimizerdetailing the connectivity of the flow controller (marked handleassembly) with sources of saline and CO₂ and the insufflator trocar, andwith the and guard tube (marked sheath assembly) which is adapted toreceive the surgical scope;

FIG. 12 shows three views of the exemplary embodiment of the viewoptimizer shown in FIG. 2C as packaged,

FIG. 13 shows a scaled drawing (0.250) of the exemplary embodiment ofthe view optimizer shown in FIG. 12, coiled for packaging;

FIG. 14 is a photograph of the view optimizer embodiment of FIG. 2C andFIG. 3A with annotations identifying kit components and alternatedescriptors for view optimizer components;

FIG. 15A shows a front perspective view of a surgical scope stabilizer;

FIG. 15B upper panel is a bottom side view thereof; lower panel is abottom perspective view thereof;

FIG. 15C is a front perspective view of a surgical scope stabilizer inthe environment of a sheath manifold and surgical scope;

FIG. 16 shows an exploded perspective view of the components of thescope locking mechanism, which include a locking knob, cam grip,manifold and sheath;

FIG. 17A shows an alternate perspective view of the components of thecam grip shown in FIG. 16;

FIG. 17B shows an alternate perspective view of the components of thecam grip shown in FIG. 16;

FIG. 17C shows a side perspective view of the cam grip with alaparoscope inserted therethrough;

FIG. 18A shows a perspective view of the bottom of the locking knob andcam grip components;

FIG. 18B shows a top perspective view of the of the locking knob and camgrip components;

FIG. 18C shows a bottom perspective view of the locking knob and camgrip engaged;

FIG. 19A shows a side perspective view of the manifold partiallydisassembled;

FIG. 19B shows a top plan view of the partially disassembled manifoldshown in FIG. 19A; and

FIG. 19C shows an alternate side perspective view of the partiallydisassembled manifold shown in FIG. 19A.

DETAILED DESCRIPTION OF THE INVENTION

The present invention will now be described with occasional reference tospecific embodiments of the invention. This invention may, however, beembodied in different forms and should not be construed as limited tothe embodiments set forth herein. Rather, these embodiments are providedso that this disclosure will fully convey the scope of the invention tothose skilled in the art.

Except as otherwise specifically defined herein, all terms used hereinhave the same meaning as commonly understood by one of ordinary skill inthe art to which this invention belongs. The terminology used in thedescription of the invention herein is for describing particularembodiments only, and is not intended to be limiting of the invention.As used in the description of the invention and the appended claims, thesingular forms “a,” “an,” and “the” are intended to include the pluralforms as well, unless the context clearly indicates otherwise.

Unless otherwise indicated, all numbers expressing quantities,properties, and so forth as used in the specification and claims are tobe understood as being modified in all instances by the term “about.”Accordingly, unless otherwise indicated, the numerical properties setforth in the following specification and claims are approximations thatmay vary depending on the desired properties sought to be obtained inembodiments of the present invention. Notwithstanding that the numericalranges and parameters setting forth the broad scope of the invention areapproximations, the numerical values to the extent that such are setforth in the specific examples are reported as precisely as possible.Any numerical values, however, inherently contain certain errorsnecessarily resulting from error found in their respective measurements.

Described herein are various embodiments of a device for use withsurgical scopes. In some embodiments, this application relates tovarious embodiments of view optimizer devices of varying constructionsfor use with laparoscopes, the view optimizer device being adapted toshield, defog or clean the lens of the laparoscope while the laparoscopeis being used to perform a surgical procedure within a patient's body,thereby enhancing patient safety by maintaining clear and stablevisualization of the surgical field. In certain embodiments disclosedherein the devices are adapted to connect with the insufflation circuitand irrigation systems resident in the standard surgical suite,diverting only a small fraction of the flow from these systems toprovide device functionality and requiring no power source. The devicesfunction to prevent fogging and deflect and remove from the lens of thesurgical scope solid and aerosolized surgical debris, including blood,smoke, saline, tissue and other materials and debris in the surgicalfield. These functions are achieved through means that includeintermittent or continuous flow of gas, typically CO₂, across the distalend, delivery by manual or automated means of a saline flush or a CO₂burst over the lens, and venting through either a conventional trocar orother means incorporated in the inventive devices. The device functionsare achieved without the need for withdrawal of the surgical scope fromthe surgical trocar so as to enable maintenance if the surgical image.Though the various device embodiments are referred to herein as a viewoptimizer, and though the various device component parts and functionshave likewise been given descriptors herein, it will be appreciated thatsuch descriptor designations are not intended to and do not limit in anyway the device's and component's use and operation for a variety ofpurposes as further described herein in addition to controlling,improving and maintaining and improving desirable visualization of alaparoscopic surgical field.

Conventional Devices

Referring to FIG. 1A, a perspective view of an exemplary, conventionallaparoscope 100 is shown. The laparoscope 100 has an elongatedcylindrical main body 110 having a distal end 120 and an imaging end130. The main body 110 of the laparoscope may be either rigid orflexible, depending on the procedure the laparoscope is being used toperform, as well as the type of laparoscope being utilized. An objectivelens (not shown in FIG. 1A) is disposed within the distal end 120 of themain body 110, the objective lens being generally transverse to thelongitudinal axis of the main body 100. Generally, laparoscope 100includes an illumination system, which can be any type of suitableillumination system, such as a network of fiber optic cables, housedwithin the main body 110 of laparoscope 100 for illuminating thesurgical site being imaged by the operative lens of the laparoscope.Laparoscope 100 includes an illuminator connector 140 for the connectionof an external light source, which supplies the illumination system withilluminating light.

The imaging end 130 of the main body 110 of the laparoscope 100 includesan eyepiece 150. Conventional laparoscopes include an image transmissionsystem (not shown in FIG. 1A), which can be selected from any type ofsuitable image transmission systems, such as a system of lens, lens rodsor other optical components, housed within the main body 110 of thelaparoscope for transmitting the image viewed by the objective lens tothe eyepiece 150, thus allowing the scope operator to view within thepatient's abdominal cavity. It is well known in the art that a videocamera or other visual display device can be operatively connected tothe eyepiece 150 or other portion of the laparoscope 100 to convert theoptical signal into a video signal, which is ultimately processed by avideo processing means to produce a video image on a monitor or forstorage on magnetic tape or other storage media.

Referring now to FIG. 1B, a perspective view of an exemplary,conventional trocar 800 is shown. Trocar systems are surgical devicesused to obtain access to a body cavity to perform various surgicalprocedures, such as, for example, laparoscopic surgery or arthroscopicsurgery.

It should be understood that the laparoscope device is typically used inconjunction with a trocar which directs access of the scope to thelaparoscopic surgical field. It should be further understood thatconventional trocars are, by design, adapted with cannulas that have adiameter suitable to receive conventional scopes, and that anyattachments to a conventional surgical scope, such as the view optimizerdevice and embodiments described herein, will be sized to fit over aportion of a conventional scope and capable of being inserted into thecannula of a conventional trocar. And it will be appreciated that in itsvarious embodiments, the view optimizer of the present application canbe used in connection with a variety of trocars and with a variety oflaparoscopes and other surgical scopes of varying construction whereinthe trocar is adapted to receive a scope within a cannula or like tube.

It is well known in the art that trocar systems typically include, amongvarious optional features, a pointed rod-like device or obdurator fittedinto a tube-like device or cannula and a port and a stopcock forpermitting the introduction and venting of a pressurized fluid throughthe cannula for insufflating a body cavity when providing apneumoperitoneum. In use, a pointed end of the obdurator projects out anend of a cannula and is used to penetrate the outer tissue of the bodycavity. After the tissue is penetrated and the body cavity is accessedby the trocar system, the obdurator is then withdrawn while the cannulais retained in the cavity. The body cavity can then be accessed bysurgical instruments via the cannula to perform various surgicalprocedures, or the cannula can simply be used as a drainage outlet. Thetrocar illustrated in FIG. 1B has a stopcock valve 810 for opening andclosing a port 820. The valve may be operated by hand, for example, by asurgeon or a surgical assistant, and moved between two or more positionsto control the flow of fluid, such as gas, through the cannula 830 andthus between the surgical suite and the surgical field within thepatient's body cavity.

It should be understood that the laparoscope and trocar devicesdiscussed above are representative of conventional scopes such aslaparoscopes and trocars. It should be further understood thatconventional trocars are, by design, adapted with cannulas that have adiameter suitable to receive conventional scopes, and that anyattachments to a conventional surgical scope, such as the view optimizerdevice and embodiments described herein, will be sized to fit over aportion of a conventional scope and capable of being inserted into thecannula of a conventional trocar. And it will be appreciated that in itsvarious embodiments, the view optimizer device of the presentapplication can be used in connection with a variety of trocars and witha variety of laparoscopes or other surgical scopes of varyingconstructions wherein the trocar is adapted to receive a scope within acannula or like tube.

View Optimizing Devices—General Construction

Referring now to FIG. 2A and FIG. 2C show exemplary embodiments of theview optimizer 200 of the present application having multi partconstruction, and FIG. 2B shows an exemplary embodiment having unitaryconstruction. As shown in FIGS. 2A and 2B and 2C, the view optimizer 200generally includes a lens guard 210 and a flow controller 220 (shown,respectively without and with prime (“′”) designation). The lens guard210 of the illustrated embodiment is adapted to receive a portion of thelaparoscope 100, most particularly the distal end 120 thereof, and aportion of the main body 110 of the laparoscope. The lens guard 210 ofthe illustrated embodiment is in the form of a substantially continuouscylindrical sheath or tube that encloses a significant portion of thebody of the laparoscope 100. It will be appreciated that in alternateembodiments, the lens guard 210 may be discontinuous, such that it maybe formed of an open lattice or matrix that does not fully enclose thebody of the laparoscope. As will be described further herein, the commonstructural features of the various embodiments of the lens guard 210will be adapted to allow communication between the lens guard 210 of theview optimizer 200 at the distal end 120 of the laparoscope, on the onehand, and the flow controller 220 of the view optimizer 200 on the body110 of the laparoscope near its imaging end 130, on the other hand, soas to provide for the functions of the view optimizer. Referringgenerally to the depicted devices, the view optimizer 200 is adapted todeliver to the objective lens of the laparoscope at least one fluidselected from, for example, a liquid, such as water or saline or asurfactant or other liquid, and a gas, such as CO₂ or air, to preventthe contact of material with the objective lens of the laparoscope or todefog or clean the objective lens of the laparoscope without the need toremove the laparoscope from the surgical field.

In accordance with some embodiments, the fluid delivered to theobjective lens is a gas, in some embodiments, the gas is medical gradeCO₂. The gas that is delivered to the objective lens of the laparoscope100 by the view optimizer 200 is supplied by a conventional insufflator.Of course, it should be understood that the view optimizer 200 of thisapplication could be supplied with gas via another external source otherthan an insufflator, or could include a gas supply device incorporatedwithin or provided with the view optimizer 200, or by combinations ofgas sources. Conventional insufflators are designed to insufflate apatient's abdominal cavity until a pre-determined suitable pressure forthe operative procedure is reached. Once this pre-determined pressure isreached, conventional insufflators are designed to cease insufflatingthe cavity. Typical insufflators are designed to resume insufflationonce the pressure in the cavity drops below the pre-determined pressuredue to the leakage of gas through the trocars being used, throughincisions in the patient's body cavity, or by some other means. In thismanner, conventional insufflators typically continuously cycle betweenan insufflation state and a static state while being utilized during anoperative procedure to maintain a pre-determined pressure within thepatient's abdominal cavity.

Referring now to FIG. 2A, the lens guard 210′ of the illustratedembodiment of the view optimizer 200 is an elongated, hollow cylindricaltube. The lens guard 210′ has a distal end 212′ and a proximal end 214′.The distal end 212′ of the lens guard 210′ is adapted to surround thedistal end 120 of the laparoscope 100. According to the illustratedembodiment, the distal end 212′ of the lens guard 210′ does not cover orfully enclose the distal end 120 of the laparoscope. It will beappreciated that in some alternate embodiments, a lens guard 210′ mayinclude structure that fully encloses the distal end 120 of thelaparoscope, and as such is formed of a material that permitsvisualization. The proximal end 214′ of the lens guard 210′ is joined tothe flow controller 220′ of the view optimizer 200. The flow controller220′ of the view optimizer 200 of the illustrated embodiment is adaptedto support and enclose components of the view optimizer 200. The flowcontroller 220′ of the of the view optimizer 200 supplies the lens guard210′ with gas and/or liquid via one or more of conduits that connect tolens guard 210′. The flow controller 220′ receives gas and/or liquidfrom one or more exterior sources via air inlet 230 and liquid inlet 240and delivers the gas and/or liquid to the lens guard 210′. The flowcontroller 220′ of the illustrated embodiment includes a gas/liquid flowactuator/regulator 250′ for the actuation and/or regulation of the flowof gas and/or liquid to the lens guard 210′. The flow controller 220′ ofthe illustrated embodiment includes a burst flow actuator/regulator 260′for the actuation and/or regulation of the delivery of a burst or bolusof gas and/or liquid to the lens guard 210′, as described herein.

FIG. 2B shows the lens guard 210 and the flow controller 220 of the viewoptimizer 200 joined together as a unitary construction. It should beunderstood that the lens guard 210 and the flow controller 220 could beprovided as two or more separate pieces that are used remotely from oneanother and not joined together as a unitary construction. FIG. 2A showsa side view of another exemplary embodiment of the view optimizer 200 ofthe present application. In this embodiment, the view optimizer 200 isin two separate pieces (as previously noted, the prime designation, e.g.210′, is used to reference features that are common between theembodiments depicted in FIG. 2A and FIG. 2B and FIG. 2C). The lens guard210′ is attached at its proximal end 214 to the laparoscope 100, andcomprises a vent actuator 280, and a fluid conduit 270 that is incommunication with the flow controller 220′ (connection not shown). Theflow controller 220′ is depicted as an ergonomic device to be grasped inan operator's hand, with a flow actuator/regulator 250′ adapted to bedepressed by the operator's thumb, and a burst flow actuator/regulator260′ adapted to be depressed by the flexion of the operator's fingers,to deliver the flow of gas or liquid from one or more inlet sources (notshown) through the fluid conduit 270, for delivery to the objective lensof the scope through distal end 212 of the lens guard 210. In thedepicted embodiment, the vent actuator 280 is under the control of thescope operator, and may be adjusted as needed to assist in maintainingvisualization.

Of course it will be understood that in yet other alternate embodiments,one or more of the actuators may be eliminated, and their locations maybe switched, or all actuators may be located on the flow controller 220′or may be located at yet another controller, such as a separate footactivated controller (not shown). In yet other embodiments, the lensguard 210 and 210′ and the flow controller 220 and 220′ could beprovided as two or more separate pieces that are assembled for use. Andit will further be appreciated that the two or more separate pieces thatcomprise the view optimizer 200 may comprise a lens guard 210/210′ thatis separate from the flow controller 220/220′ and the lens guard andflow controllers are interconnected by one or more conduits forproviding fluid flow. Once such embodiment is depicted in FIG. 2C, forexample.

While the lens guard 210 and 210′ and the flow controller 220 and 220′of the illustrated embodiments are formed from plastic, other suitablematerials, such as metal or a composite material, or combinations ofthese could also be used.

According to some embodiments, the view optimizer 200 is adapted todeliver a stream of fluid to the objective lens of the laparoscope so asto create a current passing over the face of the lens that transportsmoisture located on or near the lens away from the lens, thus preventingmoisture from adhering to the lens. In additional embodiments, the viewoptimizer 200 delivers a stream of fluid to the objective lens at atemperature that is adapted to help ensure that the temperature of theobjective lens does not fall to a point that is at or below the dewpoint temperature within the patient's abdominal cavity, thus preventingcondensation from forming on the lens. Finally, in yet additionalembodiments, the view optimizer 200 is adapted to deliver a stream ofgenerally anhydrous fluid to the objective lens. In such embodiments,the generally anhydrous fluid serves to attract and absorb moistureparticles located on or near the lens and carry the moisture away fromthe lens with the flow of fluid. In some embodiments, the fluid ismedical grade CO₂. Medical grade CO₂ for use with conventionalinsufflators is typically 99% pure, that is, no more than 1% of the gasis other than CO₂, and such medical grade CO₂ generally has a maximummoisture content of 25 parts per million by volume.

It should be understood that additional embodiments of the viewoptimizer 200 may perform only one of the above-described functions orany combination of these functions. Based on testing that was conductedin connection with the view optimizer 200 of the illustrated embodiment,when the temperature within the patient's abdomen was approximately102.9° F. and the relative humidity within the patient's abdomen was76%, the delivery of a stream of fluid to the objective lens of thelaparoscope 100 at a flow rate of equal to or greater than 0.07 litersper minute proved to be effective for defogging the lens (and/orpreventing the fogging of the lens). It should be understood, however,that a variety of different flow rates will be effective for defoggingthe lens depending on the temperature and the moisture content of thegas being supplied by the insufflator and the temperature and relativehumidity of the patient's abdomen as well as other variables. As a wayof illustrating the defogging effects of the view optimizer 200according to one embodiment, the information regarding the dew pointtemperature of the objective lens of the laparoscope was collected whenthe view optimizer 200 was located within the patient's abdominalcavity.

According to some embodiments, the view optimizer 200 is adapted todeliver a stream of one or more fluids across the objective lens of thelaparoscope 100 to deflect blood, bodily fluids, pieces of tissue, fator other bodily material that come within the vicinity of the objectivelens. The stream of fluid may be either continuous or intermittent. Inaddition, according to some embodiments, the view optimizer 200 isadapted to deliver a burst or bolus of gas and/or liquid to theobjective lens of the laparoscope when the scope operator desires. Thisburst or bolus of gas and/or liquid serves, at least in part, tofacilitate removal of blood, bodily fluids, pieces of tissue, fat orother bodily material on the objective lens. In this manner, the scopeoperator can deliver a burst of gas or liquid to the objective lens toremove a piece of material or droplet of liquid, which was otherwiseunable to be removed from the objective lens. It should be understoodthat additional embodiments of the view optimizer 200 may perform onlyone of the above-described functions or any combination of thesefunctions.

According to various embodiments, the view optimizer 200 delivers gas tothe lens of the laparoscope so as to provide a guard or shield todeflect liquid and particulate debris and prevent it from contacting thelens. According to some embodiments, the gas delivery is intermittent.According to other embodiments, such as the embodiment illustrated inany one of FIG. 2A-2C, the flow of gas is essentially continuous. Assuch, the flow of gas during operation of the view optimizer 200 flowsconstantly, with delays of flow that are of a duration not greater than5 seconds. Accordingly, in various embodiments wherein the flow of gasis essentially continuous, delays in flow are of a duration that is notgreater than about 0.2, 0.4, 0.6, 0.8, 1.0, 2, 3, 4, or 5 seconds.

As is further described herein, the embodiment of the view optimizer 200illustrated in any one of FIG. 2A-2C is supplied with gas by theinsufflator comprises one or more of a variety of means to permit anessentially uninterrupted supply of gas to be directed across theobjective lens of the laparoscope 100. Accordingly, the illustratedembodiment includes a leakage or venting of gas from the body cavity soas to ensure continuous gas flow from the insufflator. This leak allowsgas to exit the patient's abdominal cavity as necessary to ensure thatthe insufflator remains substantially in an insufflation state, thussupplying the view optimizer 200 with a generally continuous supply ofgas.

As previously described, the lens guard 210 is an elongated, cylindricaltube. However, it should be understood that that the lens guard 210 isnot limited to this shape and configuration and other suitable shapesand configurations could also be used in additional embodiments.Examples of additional constructions have been previously described.Examples of additional cross-sectional shapes that could be used for thelens guard 210 include, but are not limited to, rectangular, triangular,oval, etc. The lens guard 210 can have any shape or configuration whichallows it to surround the distal tip 120 of the laparoscope 100.

Additional embodiments of the view optimizer 200 may include a lensguard which has an angled portion to correspond with scopes with angledportions, such as 45° or 30° angled scopes. The lens guard 210 of theillustrated embodiment is substantially rigid. However, it should beunderstood that additional embodiments of the view optimizer may includea flexible lens guard, which is adapted for use with a flexible scope.For example, the lens guard 210 of the embodiment illustrated in FIG. 2Ais fashioned from plastic, but other suitable materials such as metal ora composite material or combinations of these could also be used.

While the view optimizer 200 of the illustrated embodiment includes alens guard 210 that surrounds and encloses the entire length of thelaparoscope 100, it should be understood that the lens guard 210 of theview optimizer 200 could have any shape, construction or configurationthat allows it to deliver gas and/or liquid to the objective lens of thelaparoscope 100. For example, in alternative embodiments the lens guard210 could be formed of one or more channels, tubes or conduits adaptedto deliver gas and/or liquid to the objective lens of the laparoscope100. The channels, tubes or conduits of such embodiments of the lensguard 210 could be supported by a rigid or flexible framework. Thechannels, tubes or conduits of such embodiments could also be fastenedto the laparoscope 100 itself, either removably or permanently, by oneor more fasteners, such as straps, ties, adhesives, clips, etc. In suchembodiments, additional methods of sealing the interface between theview optimizer 200 and the trocar may be employed. For example, theportion of the view optimizer 200 that interfaces with the trocar may bea member that serves to form a seal with the trocar while the portion ofthe view optimizer 200 that is inserted into the patient's body cavityand delivers gas and/or liquid to the objective lens of the laparoscopecould be one or more channel, tube or conduit and/or a rigid or flexibleframework In addition, the lens guard 210 of additional embodimentscould be adapted to surround and enclose only portions of thelaparoscope 100, leaving other portions of the laparoscope 100 open andfree from enclosure.

View Optimizer Stabilization: Scope Stabilizer

Referring again to FIG. 2C, upper panel, the depicted exemplaryembodiment of the view optimizer is a two-part design, comprising a lensguard that engages with a scope and a flow controller that is used tocontrol and modulate various functions of the view optimizer. Asdepicted, the flow controller and the lens guard are in communicationwith one another via tubing elements that are in turn adapted to be incommunication with one or more of water, gas and other sources. FIGS.10, 4J and 4K, respectively, show perspective views of the flowcontroller 220 and lens guard 210 components shown in FIG. 2C. In itsvarious embodiments, the view optimizer 200 is adapted to deliver to theobjective lens of the laparoscope at least one fluid selected from, forexample, a liquid, such as water or saline or a surfactant or otherliquid, and a gas, such as CO₂ or air, to prevent the contact ofmaterial with the objective lens of the laparoscope or to defog or cleanthe objective lens of the laparoscope without the need to remove thelaparoscope from the surgical field.

Referring now to FIG. 4J, the lens guard 210 of the illustratedembodiment is adapted to receive a portion of the laparoscope 100, mostparticularly the distal end 120 thereof, and a portion of the main body110 of the laparoscope. The lens guard 210 can have any shape orconfiguration which allows it to surround the distal tip 120 of thelaparoscope 100. Additional embodiments of the view optimizer 200 mayinclude a lens guard which has an angled portion to correspond withscopes with angled portions, such as 45° or 30° angled scopes. Forexample, the lens guard 210 may be provided in a sheath configurationthat has a zero angle or flat distal end 212 that corresponds with anon-angled scope. And in other embodiments, the lens guard 210 may beprovided in a sheath configuration that has an angle other than zero atits distal end 212, where such angle corresponds to angled surgicalscopes having standard angles of 45° or 30°, or, as will be appreciatedby one of skill in the art, the tip may correspond to some other angleas may exist in the scope art. FIG. 4D-4F shows some embodiments ofalternate tip configurations. FIGS. 4G-4I show different views of anembodiment of a lens guard tip. Thus, it will be appreciated that inaccordance with the various possible lens guard 210 configurations thatcan be provided, any angle of scope can be accommodated simply byvarying the angle of the distal end 212 of the lens guard 200.

With respect to those lens guard 210 embodiments that have an angleother than zero at their distal end 211 for receiving variously angledscopes, proper alignment of the scope with the lens guard 210 is ofimportance to ensure proper function of the view optimizer 200 and toavoid disruption or fracture of the tip of the lens guard 210.Accordingly, a scope stabilizer is provided that serves the dual purposeof proper alignment of the scope when inserted into the lens guard 210and maintenance and stabilization of that alignment during use.Referring again to FIGS. 4J and 4K, the scope stabilizer 1000 is shownengaged with the manifold 900 portion of the lens guard 210. Thedepicted scope stabilizer 1000 has a generally Y or fork-shapedconfiguration that has a proximal end for engagement with the lens guard210 and a distal end for initially receiving and guiding a scope intoposition. The stabilizer 1000 has with two opposing parallel extensionarms that are merged into a central base at the proximal end and extendto their tips a the distal end and form a channel there between that isadapted to receive the illuminator connector 140 portion of the scope.The channel serves to guide the scope as it is inserted into properengagements with the lens guard 210, and the arms forming the channelmaintain the scope in proper position throughout the use of the viewoptimizer 200. FIGS. 15A-15C show various views of the scope stabilizer1000, and FIG. 15C shows the scope stabilizer 1000 engaged with the lensguard 210 and an exemplary scope that is depicted in phantom (brokenlines).

It will be understood that while the depicted embodiment of the scopestabilizer 1000 is constructed as a separate piece that is removablyengageable with the manifold 900 of the lens guard 210, otherembodiments are possible. Thus, the scope stabilizer 1000 may be formedin combination with one or more components of the lens guard 210, and assuch, may be integrated with the manifold 900, or with some othercomponent of the lens guard 210. It will also be understood that as aseparate component, the scope stabilizer 1000 may be removablyengageable by a variety of attachment means. As depicted, the scopestabilizer 1000 engages with the manifold 900 via a tab at its proximalend that inserts into a slot in the manifold 900. A variety of othermeans of attachment that are known in the art may be used, some of whichmay preclude removable engagement: such attachment or fasteners caninclude, but are not limited to, any type of screws or bolts, anchors,rivets, cotter pins, clips, snaps, straps, ties, adhesives, weldments,and the like.

As previously described, engagement of a scope with the lens guard 210involves insertion of the scope through the lens guard 210 with properorientation of the scope tip and the lens guard 210 tip. The disclosedscope stabilizer 1000 functions to guide and maintain stable orientationof the scope with the lens guard 210. Additional features of the lensguard 210 also operate to achieve and maintain stable engagement betweenan engaged scope and the lens guard 210. Referring again to FIG. 4K, thelens guard 210 includes structures that achieve and maintain engagementbetween the scope and the lens guard 210.

View Optimizer Construction

Referring now to FIG. 3A and FIG. 3B, the view optimizer 200 will now bedescribed with more particularity. In some embodiments, such as shown inFIG. 2A and FIG. 2C, and as shown in FIG. 3A, the view optimizer 200 isformed of discrete components that are interconnected, typically withtubing for transporting fluid. FIG. 3A in four panels shows an explodedview of the device of FIG. 2C, which includes a hand held flowcontroller 220 connectable to a lens guard 210 via two or more tubingconduits. The various features and functionalities of devices accordingto this construction may be resident on one or both of the flowcontroller 220 and lens guard 210 components. That is, the controls forflow of liquid or gas, and delivery of a bolus or burst, as well ascontrol of venting may be actuated from one or both components accordingto the various aspects of the disclosure herein. Moreover, the devicecomponents may be formed of one or multiple subcomponents as shown anddescribed herein, such components and subcomponents beinginter-connectable using connections and fastener means known in the artand as described variously herein.

In other embodiments, such as shown in FIG. 2B, and as shown in FIG. 3B,the view optimizer 200 is of unitary construction, and The variousfeatures and functionalities of devices according to this constructionmay be resident on one or both of the flow controller 220 and lens guard210 components. That is, the controls for flow of liquid or gas, anddelivery of a bolus or burst, as well as control of venting may beactuated from one or both components according to the various aspects ofthe disclosure herein. Moreover, the device components may be formed ofone or multiple subcomponents as shown and described herein, suchcomponents and subcomponents being inter-connectable using connectionsand fastener means known in the art and as described variously herein.

The view optimizers illustrated in FIG. 3A-3B are shown with distal end212 configurations that are zero angle. In accordance with thedescription provided herein, the view optimizer 200 could be alternatelyconfigured to be provided in one or more of an array of configurations.For example, referring to FIG. 4D-4F, the lens guard 210 may be providedin a sheath configuration that has a zero angle or flat distal end 212that corresponds with a non-angled scope (FIG. 4D). And in otherembodiments, the lens guard 210 may be provided in a sheathconfiguration that has an angle other than zero at its distal end 212,where such angle corresponds to angled surgical scopes having standardangles of 45° (as shown in FIG. 4E) or 30° (as shown in FIG. 4E), or, aswill be appreciated by one of skill in the art, the tip may correspondto some other angle as may exist in the scope art. Thus, it will beappreciated that in accordance with the various possible lens guard 210configurations that can be provided, any angle of scope can beaccommodated simply by varying the angle of the distal end 212 of thelens guard 200.

It will be further appreciated that the components of the lens guard 210may be in multiple parts as described with respect to several of theillustrated embodiments as shown in FIG. 3B and FIG. 4A-C herein, or thelens guard 210 may alternatively be formed from fewer pieces such asdepicted in FIG. 4D-F, and in FIG. 9, or in a single piece. According toembodiments of the lens guard 210 that are formed of two or multiplepieces, the discrete pieces may be connected by any one or combinationof fastening means, such as, for example, tongue and groove, threaded,snap fit, or other fastening means as described herein or more generallyknown in the art.

The illustrated embodiments of the view optimizer 200 are adapted todeliver a generally continuous flow of gas to the objective lens of alaparoscope 100 via end ring 308 of the lens guard 210 for the cleaningand/or defogging of the lens and to deliver a flow of liquid to theobjective lens of the laparoscope 100 when the operator desires. Itshould be understood that additional embodiments of the view optimizer200 may be adapted to deliver a generally continuous flow of only liquidto the objective lens of the laparoscope 200 or both liquid and gassimultaneously. In addition, additional embodiments of the viewoptimizer 200 may be adapted to not deliver a continuous flow of gasand/or liquid but, rather, be adapted to only deliver a flow of gasand/or liquid upon the activation of an actuation device.

The illustrated embodiment of the view optimizer 200 is also adapted todeliver a burst or bolus of gas to the objective lens of the laparoscopeupon the activation of a burst actuator/regulator 260. It should beunderstood that additional embodiments of the view optimizer may beadapted to deliver a burst or bolus of liquid to the objective lens ofthe laparoscope 200. It should also be understood that additionalembodiments of the view optimizer may be provided without this burstfunction.

Finally, the illustrated embodiment of the view optimizer 200 is adaptedto create a controlled leak of the gases from within the patientsabdominal cavity to ensure that the insufflator does not turn off duringa surgical procedure or to diminish the frequency of such stoppages ofthe insufflator. It should be understood that all embodiments of theview optimizer do not include such a controlled leak function. Inaddition, yet additional embodiments of the view optimizer 200 maycreate a steady leak, which is not controllable by the operator.

View Optimizing Devices—Lens Guard Distal End Construction

Referring again to FIG. 3B, the lens guard 210 of the illustratedembodiment includes an adapter ring 302, a guard tube 304, an exhaustring 306, and an end ring 308. FIG. 4A-4C provide additional detailregarding the tip of the lens guard 210. Referring first to FIG. 4A, theguard tube 304 is shown with more particularity (the exhaust ring 306and end ring 308 of the lens guard 210 are not present in FIG. 4A tobetter illustrate the construction of the guard tube 304). As shown inFIG. 4A, the guard tube 304 is a hollow, cylindrical tube adapted tosurround the laparoscope 100. The guard tube 304 has an outer wall 510that defines a hollow space. Also as shown in FIG. 4A, channels 512 aredefined within the outer wall 510 and extend the length of the guardtube 304. The channels 512 are adapted to allow for the travel of gasand/or fluid along the length of the guard tube 318. The guard tube 304depicted in the figures includes six channels 512, each having one ormore functions. However, it should be understood that additionalembodiments of the view optimizer may include any number of channels 512defined within the guard tube 318, such as, for example, a singlechannel for multiple functions, or two or more channels each havingdistinct functions. The channels 512 may have a variety of sizes, shapesand configurations that allow for the passage of gas and/or liquid. Theguard tube 318 of the illustrated embodiment shown in FIG. 5 has twochannels 512 for the passage of exhaust gas from the interior of thepatient's body cavity, and is suitable for providing a controlled leak.The illustrated embodiment also includes two channels dedicated todelivery of gas from the insufflator to the objective lens of thelaparoscope 100, and one channel for the passage of the liquid to theobjective lens of the laparoscope. Additional embodiments of the viewoptimizer 200 may include guard tubes 304 that have any number ofchannels 512 dedicated to any combination of gas for delivery to theobjective lens of the laparoscope, liquid for delivery to the objectivelens of the laparoscope, and/or exhaust gas. As mentioned previously,various additional embodiments of the view optimizer 200 may utilizeboth gas and liquid or only one of gas or liquid for delivery to theobjective lens of the laparoscope. In some embodiments, the viewoptimizer may lack exhaust channels. Generally, depending on theintended functionality of the lens guard, the one or multiple channels512 of the guard tube 304 will be suitably adapted.

Referring now to FIG. 4B, the guard tube 304 and exhaust ring 306 of thelens guard 210 are shown in use with a laparoscope 100 (the end ring 308of the lens guard 210 is not shown in FIG. 4B to better illustrate theconstruction of the exhaust ring 306). The exhaust ring 306 is a hollow,cylindrical piece adapted to surround and enclose a portion of thelaparoscope 100. As shown in FIG. 4B, the guard tube 304 and the exhaustring 306 of the view optimizer 200 are attached together. The guard tube304 and the exhaust ring 306 can be attached together in a variety ofdifferent ways, such as by adhesives, screws, tabs and slots, etc. Inaddition, the guard tube 304 and exhaust ring 306 could be formedtogether as a unitary construction.

The exhaust ring 306 has an outer wall 514 which defines a hollow space.Exhaust vents 516 are defined within the outer wall 514 of the exhaustring 306. As shown in FIG. 4B, the guard tube 304 and the exhaust ring306 abut against one another when the lens guard 210 is assembled. Theexhaust vents 516 defined within the outer wall 514 of the exhaust ring306 are adapted to form openings into two of the channels 512 of theguard tube 304 that are dedicated to the passage of exhaust gas fromwithin the patient's body cavity in conjunction with the leak functionof the view optimizer 200 of the illustrated embodiment. The pressurewithin the patient's body cavity is greater than the pressure within thechannels 512 of the guard tube 304. Accordingly, gas from within thepatient's body cavity will enter the exhaust vents 516 and travelthrough the channels 512 defined within the guard tube 304 out of andaway from the patient's body cavity. While the embodiment of the exhaustring 306 illustrated in FIG. 4B includes two exhaust vents 516,additional embodiments of the view optimizer 200 may include exhaustrings 306 with any number of exhaust vents. The exhaust vents 516 mayhave any shape, size and configuration which allows gas to enter theguard tube 306 or some other portion of the view optimizer 200. Asdiscussed above, additional embodiments of the view optimizer 200 maylack a controlled leak function, thus, such embodiments of the viewoptimizer 200 will not include exhaust vents 516.

Referring again to FIG. 4B, channels 518, 520, 521 and 522 are definedwithin the outer wall 514 of the exhaust ring 306 and extend through thelength of the exhaust ring 306. The channels are adapted to allow forthe travel of either gas and/or liquid along the length of the exhaustring 306. When the lens guard 210 is assembled, each of the channels518, 520, 521 and 522 of the exhaust ring 306 align with a channel 512of the guard tube 304 to allow for the passage of gas and/or liquidtherethrough. While the exhaust ring 306 of the illustrated embodimentincludes four channels, additional embodiments of the view optimizer mayinclude exhaust rings 306 with any number of channels.

As depicted, channel 518 of the exhaust ring 306 of the illustratedembodiment is adapted for the passage of liquid for delivering to theobjective lens of the laparoscope 100. Channels 520, 521 are adapted forthe passage of gas for delivery to the objective lens of the laparoscope100. Channel 522 of the exhaust ring 306 of the illustrated embodimentsis not operative to allow for the passage of either gas and/or liquid.However, in additional embodiments, channel 522 could be functional.Channel 522 could act as an exhaust channel for both fluid and gas.While the exhaust ring 306 includes four channels, it should beunderstood that additional embodiments of the exhaust ring 306 mayinclude any number of channels. The channels 518, 520, 521 and 522 mayhave a variety of sizes, shapes and configurations. The channels 518,520, 521 and 522 can have any size, shape and configuration that allowsfor the passage of gas and/or liquid. As mentioned previously, variousadditional embodiments of the view optimizer 200 may utilize both gasand liquid or one of gas or liquid for delivery to the objective lens ofthe laparoscope for cleaning and/or defogging. Accordingly, such factorswill determine the usage and number of channels as well as theconstruction, size, shape and configuration of the end ring 308 ofadditional embodiments of the view optimizer 200.

As shown in FIG. 4B, the exhaust ring 306 includes fastener openings 523for use in the attachment of the end ring 308. As shown in FIG. 4C, theexhaust ring 306 and the end ring 308 of the view optimizer 200 areattached together. The exhaust ring 306 and the end ring 308 of theillustrated embodiment are attached together by projections (not shown)which extend from the end ring 308 and are received within the fasteneropenings 523 of the exhaust ring 306. However, it should be understoodthat the end ring 308 and the exhaust ring 306 can be attached togetherin a variety of different ways, such as by adhesives, screws, tabs andslots, etc. In addition, the end ring 308 and exhaust ring 306 could beformed together as a unitary construction.

Referring now to FIG. 4C the guard tube 304, exhaust ring 306 and endring 308 are shown in use with a laparoscope 100. The end ring 308 isattached to the exhaust ring 306 and extends beyond the end of thelaparoscope 100. This extension of the end ring 308 beyond the distalend 120 of the laparoscope 100 facilitates delivery of fluid to thelens, as further described herein, and helps to shield the objectivelens from contacting objects or tissue, either within the patient's bodycavity or outside of it, such as within the passageway within a trocar,that may soil, smudge, smear or adhere to the objective lens of thelaparoscope. For example, conventional trocars include a seal assemblythat consists of a plurality of flaps that create a seal with objectsthat are inserted through the trocar. These flaps of the trocar seal canbecome soiled with blood, bodily fluids, pieces of tissue, fat or otherbodily material during an operative procedure. The extension of the endring 308 beyond the distal end 120 of the laparoscope 100 serves tocontact these flaps prior to the laparoscope 100 as the laparoscope 100and view optimizer 200 are being inserted through the trocar, therebydeflecting the soiled flaps away from contacting the objective lens ofthe laparoscope 100, and thus, preventing any blood, bodily material orother matter that is on the flaps from contacting and/or dirtying theobjective lens. Likewise, the extension of the end ring 308 beyond thedistal end 120 of the laparoscope also serves to deflect objects, suchas internal organs or other tissue or fat, from contacting the objectivelens of the laparoscope 200 when within the patient's body cavity.

According to various embodiments, the end ring 308 portion of the viewoptimizer 200 may extend beyond the end of the laparoscope from about 0mm to about 7 mm, Accordingly, in various embodiments, the end ring 308portion of the view optimizer 200 may extend beyond the end of thelaparoscope from about 0, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 4.5, 5, 5.5,6, 6.5, 7 mm or more. It should be understood that additionalembodiments of the view optimizer 200 may not include an end ring 308 orother structure that extends beyond the distal end 120 of thelaparoscope 100.

The end ring 308 is adapted to partially enclose the distal end 120 ofthe laparoscope 100. The end ring 308 has a main wall 524. Passageways526, 528, 530 and 532 are defined within the main wall 524 of the endring 308. Passageways 526, 528, 530 and 532 are adapted to direct theflow of gas and/or liquid exiting the channels 518, 520, 521 of theexhaust ring 306 across the operative lens of the distal end 120 of thelaparoscope. The passageways 526, 528, 530 and 532 of the illustratedembodiment of the view optimizer 200 direct at least a portion of theflow of gas and/or liquid across the face of the objective lens. In thesheath assembly 200 of the illustrated embodiment, passageway 526 isadapted to direct the flow of liquid from channel 518 of the exhaustring 306 across the objective lens of the laparoscope 100. Channels 528,530 of the illustrated embodiment are adapted to direct the flow of thegas from channels 520, 521 of the exhaust ring 306 across the objectivelens of the laparoscope 100 to deflect gas and liquid from the lens,defog the objective lens as well as to remove moisture or material fromthe surface of the objective lens. Channels 528, 530 are also adapted todirect at least a portion of the gas from channels 520, 521 in a paththat projects forward from the objective lens (as viewed in FIG. 4C) atan angle relative to the objective lens. The flow of the gas that isdirected forward from the distal end 120 of the laparoscope furtherserves to deflect away smoke, particulate, blood, bodily fluid,moisture, tissue, fat, or other material within the patient's bodycavity from contacting the objective lens of the laparoscope 100.Accordingly, as the laparoscope 100 is inserted into the patient's bodycavity and/or moved within the cavity, this forwardly projecting flow ofgas serves to deflect away blood or other material that approaches theobjective lens.

It should be understood that additional embodiments of the viewoptimizer 200 could direct all of the gas and/or liquid across theobjective lens in a path that is generally parallel to the objectivelens or could direct all of the gas and/or liquid in a path projectingforward and away from the distal end 120 of the laparoscope at an anglerelative to the objective lens, or could direct all or a portion of thegas and/or liquid in a path projecting toward the distal end 120 of thelaparoscope 100 at an angle relative to the objective lens, or anycombination of parallel flow and angled flow.

Embodiments of the view optimizer 200 may provide for the delivery ofgas and/or liquid in a path having any angle relative to the objectivelens between 0° and 90° or between 0° and −90°, wherein the negativedesignation refers to paths directed toward the lens. In someembodiments, fins or louvers are provided to direct the flow of the gasand/or liquid in a variety of different paths each having a differentangle relative to the objective lens, thereby, creating a fanned outflow of gas and/or liquid. According to various embodiments, the lengthof extension of the end ring 308 portion of the view optimizer 200 thatextends beyond the end of the laparoscope from about 0 mm to about 7 mmmay comprise one or more passageways that deliver a fluid stream at oneor a range of positions along the length of the end ring 308. Accordingto such embodiments, the passageways may be positioned at the base ofthe end ring 308, near to the lens of the scope, or at the distal end ofthe end ring 308, farthest away from the lens, or at one or morelocations in between. And according to such various embodiments, thepassageways may be configured to direct a narrow stream of fluid, or maybe configured to direct a fan of fluid at various angles.

It will be appreciated then that a stream of fluid may be directed fromone or multiple channels, and that each stream may be directed within arange of possible paths from parallel to perpendicular relative to thelens, and that each such flow path may be parallel or perpendicular toor transect at some angle in between the path of another stream, andthat in some embodiments each such flow path may be directed towards thechannel from which another stream of fluid is emitted. Accordingly, insome embodiments, a stream of fluid in the form of gas may be directedtowards the channel from which another stream of gas is emitted, or astream of fluid in the form of gas may be directed towards the channelfrom which another stream of liquid is emitted, or a stream of fluid inthe form of liquid may be directed towards the channel from whichanother stream of liquid is emitted, or a stream of fluid in the form ofgas may be directed towards the channel from which another stream of gasis emitted.

The embodiment depicted in FIG. 4C is configured with an end ring 308that extends about 2 mm from the end of the laparoscope and isconfigured to deliver a fan of air at an angle of about 30°, thus thedistance of the flow path nearest the lens at the point of thepassageway is about 0 mm and the distance of the flow path nearest thelens at the opposite side of the lens is about 8 mm from the lens.Variation of the length of the end ring, distance of the passageway fromthe lens, angle or angles of flow may vary, such that the distance ofthe nearest flow path from the lens may range from 0 mm to more than 15mm, and in some embodiments the flow path may be directed at an angletoward the lens.

The end ring 308 of additional embodiments an have a variety of sizes,shapes and configurations. The end ring 308, can have any size, shape orconfiguration that allows it to direct gas and/or liquid across the faceof the objective lens of the laparoscope. While the end ring 308 of theillustrated embodiment only partially encircles the distal end 120 ofthe laparoscope 100, it should be understood that additional embodimentsof the view optimizer 200 may include an end ring 308 that completelyencircles the distal end 102 of the laparoscope 100. As mentionedpreviously, various additional embodiments of the view optimizer 200 mayutilize both gas and liquid or one of gas or liquid for delivery to theobjective lens of the laparoscope for cleaning and/or defogging. Inaddition, additional embodiments of the view optimizer 200 may notinclude a controlled leak function. Accordingly, such factors willaffect the construction, size, shape and configuration of the end ring308 of additional embodiments of the view optimizer 200.

Referring again to FIG. 3B, an adapter ring 302 is located at theproximal end 214 of the lens guard 210 to permit connection of the lensguard 210 to the flow controller 220. The adapter ring 302 is adapted tomount the lens guard 210 to the main body. The adapter ring 302 can haveany size, shape or configuration that allows it to mount the lens guard210 to the flow controller 220. In addition, as mentioned previously,the lens guard 210 and flow controller 220 of additional embodiments maybe formed as a unitary piece or may also be located remotely from oneanother and not directly connected to one another. FIG. 5A-C showsgreater detail with respect to the attachment of the lens guard 210 andthe flow controller 220. As shown in FIG. 5A, the adapter ring 302 has agenerally cylindrical shape with a guard tube opening 610 definedthrough it. The guard tube opening 610 is adapted to receive the guardtube 304. The guard tube opening 610 of the adapter ring has an innerrim 620. When the guard tube 304 is inserted into the adapter ring, theguard tube 304 abuts against the inner rim 620. In this manner, theinner rim 620 helps to properly locate the guard tube 304 within theadapter ring 302 and prevents the guard tube 304 from passing completelythrough the adapter ring 302. Several channels 630 are defined withinthe inner rim 620 of the adapter ring and pass through the length of theadapter ring 302. The adapter ring 302 of the illustrated embodiment ofthe view optimizer has six channels 630 to coincide with the sixchannels 512 of the guard tube 304. When the guard tube 304 is securedwithin the adapter ring 302, the channels 512 of the guard tube 304align with the channels 630 of the adapter ring, to allow for gas and/orliquid to flow from the channels 512 of the guard tube to the coincidingchannels 630 of the adapter ring 302 and vice versa.

While the adapter ring 302 of the illustrated embodiment includes sixchannels 630, it should be understood that additional embodiments of theadapter ring 302 may include any number of channels 630. The channels630 may have a variety of sizes, shapes and configurations. The channels630 can have any size, shape and configuration that allows for thepassage of gas and/or liquid. As mentioned previously, variousadditional embodiments of the view optimizer 200 may utilize both gasand liquid or one of gas or liquid for delivery to the objective lens ofthe laparoscope for cleaning and/or defogging. Accordingly, such factorswill determine the usage and number of channels 630 as well as theconstruction, size, shape and configuration of the adapter ring 302 ofadditional embodiments of the view optimizer 200.

As shown in FIG. 5A, a laparoscope opening 622 is defined within theinner rim 620 of the adapter ring. The laparoscope opening 622 isadapted to receive the laparoscope 100 and allow for the laparoscope 100to enter the guard tube 304. The laparoscope opening 622 may be anysize, shape or configuration that allows for the receipt of thelaparoscope 100.

Referring now to FIG. 5B, a rear perspective view of the adapter ring302 is shown. As shown in FIG. 5B, the laparoscope opening 622 extendsthrough the adapter ring 302. Also as shown in FIG. 5B, the channels 630defined within the adapter ring 302 extend to the rear of the adapterring 302 and open into arcuate shaped openings 640, 642, 644 and 646defined within the rear surface of the adapter ring 302. As can be seenin FIG. 5B, two of the channels 630 connect with opening 640, onechannel 630 connects with opening 642, two of the channels 630 connectwith opening 644 and one of the channels 630 connects with opening 646.In this manner, one pair of the channels 630 are jointly connected toopening 640 and one pair of the channels are jointly connected toopening 644. Accordingly, the gas and/or liquid traveling through suchchannels 630 will jointly flow through openings 640 and 644. Also, anygas and/or liquid which enters openings 640 or 644, will flow into thepair of channels 630 connected with opening 640 or 644. Consequently,this allows for one source of gas and/or liquid to be divided into theflow of gas and/or liquid through a pair of channels 630 of the adapterring and, consequently, a pair of channels 512 of the guard tube 304.

In the illustrated embodiment of the view optimizer 200, opening 640 isadapted to receive gas for delivery to the objective lens of thelaparoscope 100 through the lens guard 210, opening 642 is adapted toreceive liquid for delivery to the objective lens of the laparoscope 100through the lens guard 210, and opening 644 is adapted for the passageof the exhaust gases leaving the patient's body cavity via exhaust vents516 and passing through the lens guard 210. In the illustratedembodiment of the view optimizer 200, opening 646 is not operable toreceive the flow of either gas or liquid, however in additionalembodiments of the view optimizer 200, opening 646 may be functional. Asmentioned previously, various additional embodiments of the viewoptimizer 200 may utilize both gas and liquid or one of gas or liquidfor delivery to the objective lens of the laparoscope for cleaningand/or defogging. In addition, additional embodiments of the viewoptimizer may not include a controlled leak function. Accordingly, suchfactors will affect the construction, size, shape, configuration andfunctionality of the adapter ring 302, the channels 630 of the adapterring 302, and the openings 640, 642, 644, and 646 of the adapter ring302 of additional embodiments of the view optimizer 200.

Referring again to FIG. 3B, the view optimizer 200 includes a connectionplate 310 that is adapted to abut the adapter ring 302. The connectionplate 310 of the illustrated embodiment is a generally planar, circulardisc with a central opening 311 defined through it, and is adapted topermit the laparoscope 100 to pass through the connection plate 310. Theconnection plate 310 also has four openings 312 defined through itradially outward from the central opening 311. The openings 312 areadapted to receive fluid connectors 315. While the connection plate 310of the illustrated embodiment has four fluid connectors 315, additionalembodiments of the connection plate 310 may have any number of fluidconnectors 315. The connection plate 310 is adapted to abut against theadapter ring 302 and seal against the openings 640, 642, 644 and 646.Each of the four fluid connectors 315 mounted within the connectionplate 310 coincides with one of the openings 640, 642, 644 and 646 ofthe adapter ring 302 described in connection with FIG. 5. Thus, fluidflowing through one of the fluid connectors 315 is free to pass throughthe connection plate 310 into one of the openings 640, 642, 644 and 646of the adapter ring, through the channels 630 of the adapter ring,through one of the channels 512 of the guard tube, through one of thechannels of the exhaust ring and through the end ring 308 for deliveryto the objective lens. In addition, exhaust gas that enters the exhaustvents 516 may pass up the guard tube 304, through the adapter ring 302and into one of the fluid connectors 315. Additional embodiments of theview optimizer may not include a connector plate 310 or fluid connectors315.

Referring again to FIG. 5B, projecting outwardly from the adapter ring302 are three fastener portions 650, each fastener portion 640 having afastener opening defined therethrough. As shown in FIG. 6, the fastenerportions 650 are utilized to mount the adapter ring 302 and,consequently, the lens guard 210 to the flow controller 220. Additionalembodiments of the sheath assembly 200 may have any number of fastenerportions 650. The adapter ring 302 of the illustrated embodiment isattached to the flow controller 220 with conventional screws, however,other suitable fasteners, such as adhesives, rivets, tab and slots, etc.could also be used. When the adapter ring 302 and lens guard 210 aremounted to the flow controller 220, the fluid connectors 315 projectinto the interior of the flow controller 220. Also, as mentionedpreviously, the lens guard 210 and the flow controller 220 may be formedas a one-piece construction in additional embodiments of the viewoptimizer 200 or may be located remotely from one another and notdirectly connected to one another. As a result, all embodiments of theview optimizer 200 may not include an adapter ring 302. It should beunderstood that additional embodiments of the view optimizer 200 mayutilize various methods for mounting the lens guard 210 to the flowcontroller 220.

View Optimizing Devices—Flow Controller Construction

Referring again to FIG. 3B, the flow controller 220 will be describedwith more particularity. The flow controller 220 of the illustratedembodiment of the view optimizer 200 generally includes a base portion318, a handle portion 320 and an end cap 330. The base portion 318,handle portion 320 and end cap 330 of the illustrated embodiment areadapted to surround and enclose other portions of the view optimizer200. The base portion 318, handle portion 320 and end cap 330 of theillustrated embodiment are molded from plastic, however, other suitablematerials can also be used. It should be understood that the baseportion 318, handle portion 320 and end cap 330 of the view optimizer200 are not limited to the size, shape or configuration set forth inFIG. 3A or 3B. The base portion 318, handle portion 320 and end cap 330of the flow controller 220 of the view optimizer 200 can have any size,shape or configuration that can support and/or enclose other componentsof the view optimizer 200.

The base portion 318, handle portion 320 and end cap 330 are fastenedtogether with a plurality of fasteners 332. The fasteners 332 of theillustrated embodiment are conventional screws, however, it should beunderstood that any suitable attachment means could be used. Examples ofadditional fasteners that can be used include, but are not limited to,any type of screws or bolts, anchors, rivets, cotter pins, clips, snaps,straps, ties, adhesives, weldments, etc. In addition, it should beunderstood that the flow controller 220 could be formed as one unitarypiece in additional embodiments, and need not be provided as multiplepieces that are assembled together.

The base portion 318 of the flow controller 220 has an outer wall 334that defines an interior cavity 336. The configuration of the interiorcavity 336 of the base portion 318 is adapted to support and encloseother components of the view optimizer 200. A scope receiver portion 338extends from the outer wall 334 of the base portion 318 and opens intothe interior cavity 336 of the base portion 318. The scope receiverportion 338 is adapted to receive the laparoscope 100. The scopereceiver portion 338 of the illustrated embodiment of the view optimizeris a cylindrically shaped, threaded channel. However, the scope receiverportion 338 is not limited to this shape or configuration and can haveany shape or configuration that allows it to receive the laparoscope100. The scope receiver portion 338 of the illustrated embodiment isadapted to receive a grommet 340 that has a cylindrical shape with aopening defined therethrough. The grommet 340 of the illustratedembodiment is rubber, however other suitable materials may also be used,such as plastic or a composite material. The threads of the scopereceiver portion 338 are adapted to mate with the threads of a nut 342which can be tightened onto the scope receiver portion 338. The nut 342of the illustrated embodiment has an opening defined through it. Asecond opening (not shown in the figures) is defined within the bottomwall of the base portion 318 of the flow controller 220. This secondopening is in communication with the lens guard 210 that is connected tothe base portion 318 of the main body (as shown in FIG. 6).

When the view optimizer 200 is in use, the distal end 120 of the mainbody 110 of a laparoscope 100 is inserted, in turn, through the openingdefined within the nut 342, the opening defined within the grommet 340,and the opening defined within the scope receiver portion 338 by thescope operator. The main body 100 of the laparoscope 100 is then passedthrough the scope receiver portion 338 and through the base portion 318of the flow controller 220 into the lens guard 210. Once the distal end120 of the laparoscope 100 reaches the desired position within the lensguard 210, the nut 342 can be tightened down onto the threads of thescope receiver portion 338. This tightening of the nut 342 forces thegrommet 340 to be wedged between the surface of the scope receiverportion 338 and the laparoscope 100, thereby locating the laparoscope inthe desired position relative to the flow controller 220 and the lensguard 210, and preventing both linear and rotational movement of thelaparoscope relative to the flow controller 220 and the lens guard 210.However, one or both of linear or rotational movement may be allowed inalternative embodiments.

As illustrated in FIG. 3B, the handle portion 320 of the flow controller220 has a main wall 350 that defines a partially enclosed space. Theconfiguration of the handle portion 320 is adapted to support andenclose other components of the view optimizer 200. The partiallyenclosed space of the handle portion 320 abuts with the interior cavity336 of the base portion 318 so the partially enclosed space of thehandle portion 320 and the interior cavity 336 of the base portion 318are in communication when the base portion 318 and the handle portion320 are joined. Referring to the illustrated embodiment of FIG. 3B, aburst actuator compartment 352 and a gas/liquid actuator compartment 354are defined within the main wall 350 of the handle portion 320. Theburst actuator compartment 352 is adapted to hold the burst actuator 360and the gas/liquid actuator compartment 354 is adapted to hold thegas/liquid actuator/regulator 250. The burst actuator compartment 352and the gas/liquid actuator compartment 354 of the handle portion 320are in communication with each other as well as being in communicationwith the interior cavity 336 of the base portion 318.

The handle portion 320 of the illustrated embodiment of the viewoptimizer includes an end cap 330 that is removably attached to thehandle portion 320 of the flow controller 220. The end cap 330 isadapted to fully enclose the gas/liquid actuator compartment 354 of thehandle portion 320. Additional embodiments of the view optimizer 200 areprovided without such an end cap 330. As mentioned previously,additional embodiments of the view optimizer may include a one-pieceflow controller 220 as opposed to the multi-piece flow controller 220 ofthe illustrated embodiment. The main body can have any shape orconfiguration that allows it to support and/or enclose other portions ofthe view optimizer 200.

The gas inlet 230 and the fluid inlet 240 of the flow controller 220extend into the gas/liquid actuator compartment 354 of the handleportion 320 of the flow controller 220. The gas inlet 230 and the liquidinlet 240 of the illustrated embodiment of the view optimizer 200 arecylindrical tubes extending outwardly from the surface of the flowcontroller 220. The gas inlet 230 and liquid inlet 240 are formed fromplastic, but a variety of suitable materials could also be used. Itshould be mentioned that additional shapes and configurations could beused for the gas inlet 230 and liquid inlet 240. The gas inlet 230 andthe fluid inlet 240 of the flow controller 220 receive gas and liquidrespectively from external sources. The gas inlet 230 and liquid inlet240 can have any shape or configuration that allows for the connectionof the view optimizer 200 to external gas and liquid sources.

It should be understood that additional embodiments of the viewoptimizer 200 may include gas and/or liquid sources that are locatedinternally within the view optimizer 200 itself, thus eliminating theneed for a means of connecting the view optimizer 200 to externalsources of gas and/or liquid. In addition, it should also be understoodthat additional embodiments of the view optimizer utilize only gas oronly liquid. Whether or not the view optimizer 200 utilizes gas, liquid,or both will determine whether a gas or liquid inlet is provided withvarious additional embodiments of the view optimizer 200.

The gas/liquid actuator/regulator 250 of the illustrated embodiment ofthe view optimizer is housed within the gas/liquid actuator compartment354 of the handle portion 320 of the flow controller 220. The gas/liquidactuator/regulator 250 of the view optimizer 200 can be formed of one ofa variety of actuation means. The gas/liquid actuator/regulator 250 ofthe illustrated embodiment of the view optimizer 200 is a control valve,namely, a manually controlled switching valve. It should be understood,however, that additional embodiments of the view optimizer 200 mayinclude a variety of different types of gas/liquid actuator. Additionalembodiments of the view optimizer 200 may include a variety of manuallyor electrically controlled valves or other device. The gas/liquidactuator/regulator 250 may be any valve or similar device that actuatesand/or regulates the flow of the gas and/or liquid utilized by the viewoptimizer 200 for delivery to the objective lens of the laparoscope 100.The gas/liquid actuator/regulator 250 of the illustrated embodiment isformed from plastic; however, other suitable materials including metalsand composites may also be used.

The gas/liquid actuator/regulator 250 of the embodiment of the viewoptimizer 200 illustrated in FIG. 3B includes a gas inlet 358, a liquidinlet 360, a gas outlet 362 and a liquid outlet 364. Referring to FIG.3B, the gas inlet 230 of the flow controller 220 is connected to the gasinlet 358 of the gas/liquid actuator/regulator 250 and the liquid inlet240 is connected to the liquid inlet 360. The embodiment of thegas/liquid actuator/regulator 250 illustrated in FIG. 3B includes anactuation switch 366. The actuation switch 366 of the illustratedembodiment is a push-button that can be selectively operated to actuatethe gas/liquid actuator/regulator 250. However, it should be understoodthat a variety of different switches or other actuation devices can beutilized to perform this function, and the view optimizer 200 of thisapplication is not limited to a push-button type switch. The actuationswitch 366 can be any type of switch or actuation device that can serveto actuate the gas/liquid actuator.

The gas/liquid actuator/regulator 250 of the illustrated embodiment ofthe view optimizer 200 is operable to switch between two states, a gasflow state and a liquid flow state. In the gas flow state, gas from anexternal gas source, such as an insufflator in the case of theillustrated embodiment, flows through the gas inlet 230 of the flowcontroller 220, through the gas inlet 358 of the gas/liquidactuator/regulator 250, through the gas/liquid actuator/regulator 250and out the gas outlet 362 of the gas/liquid actuator/regulator 250.When the gas/liquid actuator/regulator 250 is in the gas flow state,liquid is prevented from flowing through the gas/liquidactuator/regulator 250 and out of the liquid outlet 364. Conversely,when the gas/liquid actuator/regulator 250 is in the liquid flow state,liquid from an external source flows through the liquid inlet 240 of theflow controller 220, through the liquid inlet 360 of the gas/liquidactuator/regulator 250, through the gas/liquid actuator/regulator 250and out the liquid outlet 364 of the gas/liquid actuator/regulator 250.When the gas/liquid actuator/regulator 250 is in the liquid flow state,gas is prevented from flowing through the gas/liquid actuator/regulator250 and out of the gas outlet 362.

The gas/liquid actuator/regulator 250 of the illustrated embodiment isbiased towards the gas flow state and delivers a generally continuousflow of gas when in the gas flow state. In this manner, the viewoptimizer 200 of the illustrated embodiment delivers a generallycontinuous flow of gas to the objective lens of the laparoscope 100 whenthe gas/liquid actuator/regulator 250 is in the gas flow state. Thegas/liquid actuator/regulator 250 of the illustrated embodiment remainsin the gas flow state with the view optimizer delivering a generallycontinuous flow of gas to the objective lens of the laparoscope until anoperator switches the gas/liquid actuator/regulator 250 to the liquidflow state by pressing the actuation switch 366 of the gas/liquidactuator/regulator 250. When the gas/liquid actuator/regulator 250 ofthe illustrated embodiment is switched to the liquid flow state, gas isnot permitted to flow through the gas/liquid actuator/regulator 250. Thegas/liquid actuator/regulator 250 of the illustrated embodiment onlyremains in the liquid flow state for as long as the operator is holdingthe actuation switch 366. Once the operator releases the actuationswitch 366, the gas/liquid actuator of the illustrated embodimentreturns to the gas flow state. Additional embodiments of the gasactuator/regulator 250 could remain in the liquid flow state until anoperator presses on the actuation switch 366. In additional embodimentsof the view optimizer, the actuation switch 250 may allow for the flowof both liquid and gas simultaneously. In yet additional embodiments,the gas/liquid actuator/regulator 250 may be biased towards the liquidflow state. Additionally, some view optimizers contemplated by thisdetailed description may only utilize gas or liquid and the actuationswitch 366 of such embodiments will only activate or deactivate the flowof gas or liquid not both and not switch between the flow of gas orliquid. And in still other embodiments, the apparatuses may include morethan one actuation switch, each of which independently activates anddeactivates the flow of a liquid or a gas, or combinations thereof.

The burst actuator/regulator 260 of the illustrated embodiment of theview optimizer 200 is housed within the burst actuator compartment 352of the handle portion 320 of the flow controller 220. The burstactuator/regulator 260 of the view optimizer 200 can be formed of one ofa variety of actuation means. As shown in FIG. 3B, the burstactuator/regulator 260 of the embodiment of the view optimizer 200illustrated in FIG. 3B is a manually operated, pneumatic bulb. However,it should be understood that the burst actuator/regulator 260 can be avariety of different manually or electrically operated devices. Theburst actuator/regulator 260 can be any device that allows for theactuation and/or regulation of the burst function of the view optimizer200. The burst actuator/regulator 260 of the illustrated embodiment isformed from rubber, however other suitable materials may be used. Theburst actuator/regulator 260 of the illustrated embodiment has an inlet370 and an outlet 372. The burst actuator/regulator 260 of theillustrated embodiment is adapted to deliver a burst or bolus of gasand/or liquid to the objective lens of the laparoscope 100 whenactivated by an operator. It will be understood that in various otherembodiments, the apparatuses may include more than one burst actuator,each of which is adapted to work independently to deliver a burs orbolus of a liquid or a gas, or combinations thereof.

Referring again to FIG. 3B, the gas outlet 362 of the gas/liquidactuator/regulator 250 of the illustrated embodiment of the viewoptimizer 200 is connected to the inlet 370 of the burstactuator/regulator 260. In the embodiment of the view optimizer 200illustrated in FIG. 3B, the gas/liquid actuator/regulator 250 isconnected directly to the inlet 370 of the burst actuator/regulator 260.In other embodiments of the view optimizer 200, the gas/liquidactuator/regulator 250 and the burst actuator/regulator 260 areconnected indirectly with other intermediate parts being located betweenthem, such as tubing or conduit. In addition, it should be understoodthat the gas/liquid actuator/regulator 250 and the burstactuator/regulator 260 need not be connected with one another in allembodiments of the view optimizer 200, as they may each receive gasand/or liquid from separate sources. Finally, it should be understoodthat all embodiments of the view optimizer 200 contemplated by thisdetailed description do not include both a gas/liquid actuator/regulator250 and a burst actuator, as additional embodiments may be provided withonly a gas/liquid actuator/regulator 250 or burst actuator/regulator260.

The liquid outlet 364 of the gas/liquid actuator/regulator 250 isconnected to one of the fluid connectors 313 of the connection plate bytubing (not shown) that travels through the internal cavity definedwithin the handle portion 220 and base portion 318 of the flowcontroller 220. Similarly, the outlet 372 of the burstactuator/regulator 260 is connected to one of the fluid connectors 313of the connection plate 310 by tubing (not shown) which travels throughthe internal cavity defined within the handle portion 220 and baseportion 318 of the flow controller 220. While tubing is used in someembodiments of the sheath assembly, other suitable methods could beused, such as any type of piping or conduit or flow channels definedwithin portions of the flow controller 220. The view optimizer of thisdetailed description is not limited with respect to the method which isused to connect the gas and/or liquid source to the lens guard 210 fordelivery to the objective lens of the laparoscope 100.

When the gas/liquid actuator/regulator 250 is in the gas flow state, gasflows from the gas source into the gas inlet 230 of the flow controller220, through the gas/liquid actuator/regulator 250, through the burstactuator/regulator 260, through a piece or series of tubing into a fluidconnector 313 of the connector plate 310, through opening 640 of theadapter ring 302, through a pair of channels 630 of the adapter ring302, through a pair of corresponding channels 512 of the guard tube 304,through channels 520, 521 of the exhaust ring 306, and is directedacross the lens of the laparoscope 100 by passageways 528, 530 of theend ring 308.

As the illustrated embodiment of the view optimizer 200 is adapted todeliver a generally continuous flow of gas to the objective lens of thelaparoscope 100, this cycling of the insufflator needs to be prevented.For this reason, the view optimizer 200 of the illustrated embodiment isprovided with exhaust vents 516 located within the exhaust ring 306.When the laparoscope 100 and the view optimizer 200 are inserted into apatient's abdominal cavity during a surgical procedure, the exhaustvents 516 of the exhaust ring 306 are located within the patient'sabdominal cavity. Insufflated gas present in the patient's abdominalcavity is able to enter the exhaust vents 516 and travel through a pairof the channels 512 of the guard tube 304, thus exiting the patient'sabdominal cavity. Due to the pressure differential between the interiorof the lens guard 210 and the patient's abdominal cavity, this exhaustgas travels through the channels 512 of the guard tube 304, through apair of the channels 630 of the adapter ring 302, through opening 644 ofthe adapter ring and through one of the fluid connectors 313 located inthe connection plate 310. The fluid connector 313 which the exhaust gastravels through projects into the base portion 318 of the flowcontroller 220.

As shown in FIG. 6, an exhaust valve 710 is mounted within the baseportion 318 of the flow controller 220. The fluid connector 313 throughwhich the exhaust gas from within the patient's abdominal cavity passesis connected to the exhaust valve 710 by a piece of or series of tubing(not shown). The exhaust valve 710 can be a variety of different valvesor similar devices. The exhaust valve 710 can be any device that can beused to control the flow of the exhaust gases traveling through the viewoptimizer 200. The exhaust valve 710 is in communication with exhaustvent 720 defined within the base portion 318 of the flow controller 220,which is adapted to allow the exhaust gas to exit the view optimizer tothe surroundings. The exhaust valve 710 is operable to adjust the flowrate of the exhaust gas exiting the view optimizer 200 via exhaust vent720. The controlled leak created by gas entering the lens guard 210 viathe exhaust vents 516 and exiting the view optimizer via exhaust vent720 into the surroundings helps to ensure that the pressure within thepatient's abdominal cavity remains below the pre-determined pressurethat the insufflator is set to maintain the patient's abdominal cavity.This ensures that the insufflator will continuously insufflate thepatient's abdominal cavity and will not shut off during a surgicalprocedure. Due to the fact that the insufflator is prevented fromshutting off, the view optimizer 200 of the illustrated embodiment willbe supplied with a generally continuous supply of gas for delivery tothe objective lens of the laparoscope. The flow rate of the gas exitingthe patients abdominal cavity via exhaust vents 516 can be controlledvia exhaust valve 710 to allow for the scope operator to create adesired amount of leakage from the patient's abdominal cavity, while notcompromising the effectiveness of the insufflation. As statedpreviously, however, it should be understood that additional embodimentsof the view optimizer 200 may not provide a controlled leak functionand, thus, may not include exhaust vents 516, an exhaust ring 306,exhaust valve 710 or exhaust valve 720. In addition, the view optimizerof this detailed description is not limited to the configuration setforth above with respect to the exhaust of gases from within thepatients abdominal cavity through the view optimizer, as additionalembodiments of the view optimizer may include exhaust systems that areconstructed differently.

View Optimizing Devices—Alternate Construction

Referring to FIG. 9, an alternate embodiment of a lens guard is depictedand corresponds to the lens guard shown in FIG. 2C, FIG. 3A, and FIGS.10, 12, 13 and 14. Referring to FIG. 10, an alternate embodiment of aflow controller is depicted and corresponds to the flow controller shownin FIG. 2C, FIG. 3A, and FIGS. 10, 12, 13 and 14. The device componentsshown in these various figures provide the same functionalities, namelydelivery of continuous or intermittent fluid flow at the distal end of asurgical scope, venting, and delivery of actuated liquid and gas flow.The flow controller and lens guard components according to theseillustrated and pictured embodiments are connected via one or more fluidflow conduits, as illustrated in the embodiments shown in FIG. 9, withengagement between the flow controller and lens guard achieved usingtubing connections to a flow manifold structure on the lens guard. Themanifold is adapted to receive fluid flow from one or more of liquid andgas sources that are interconnected with the flow controller throughtubing and in fluid connection with actuators on the flow controller.FIG. 10 shows the attachment positions for liquid and gas conduits. FIG.10 further illustrates an embodiment of an actuating mechanism forcontrol of liquid (saline) flow and a pin and spring construction thatprevents line crimping when liquid flow is blocked. FIG. 10 furtherillustrates an embodiment of a gas burst mechanism which is formed of abulb chamber that permits either a burst of gas or continuous gas feedto offset lag in gas flow during insufflator cycling.

Referring to FIG. 11, a schematic shows one possible configuration forinterconnection of the flow optimizer components with the saline, gas,trocar and surgical scope devices in a conventional surgical suite. Ofcourse it will be appreciated that other possible configurations may beachieved using the inventive devices and methods described herein.

Referring to FIG. 12-14, view optimizer devices corresponding with FIGS.2C and 3A are shown. FIG. 12 shows alternate photographic images of thelens guard and flow controllers connected via tubing as packaged foruse. FIG. 13 shows the coiled device as it is packaged. FIG. 14 is aphotograph of the device of FIGS. 2 and 3A annotated to show the variousconnections between the view optimizer components and to conventionalsurgical equipment.

View Optimizer Stabilization: Scope Grip

Referring now to FIG. 16, an exploded perspective view of severalcomponents of the lens guard 210 of FIGS. 4J and 4K is shown. Asdepicted, the locking knob 2000, cam grip 2200, manifold cap 2400,manifold 900 and sheath are shown substantially along the axis of theirorientation in the assembled lens guard 210. It will be appreciated thatthe locking components as depicted represent one embodiment of thecomponents of the lens guard 210, and that the specific devicecomponents and features may vary as otherwise described in connectionwith the invention, and are not intended to be limited to the depictedembodiment. The locking knob 2000 is located at the proximal end 214 ofthe lens guard 210 and functions in part to mount the lens guard 210 tothe main body of the scope.

Referring now to FIGS. 17A and 17B, the cam grip 2200 of FIG. 16 isshown in an enlarged side perspective view. FIG. 17B shows a collet 2210associated with a manifold cap 2400 and a grommet 2250 displaced fromthe collet 2210; FIG. 17A shows the collet 2210 associated with thegrommet 2250 and the manifold cap 2400 dissociated therefrom. While thecollet 2210 serves to enhance and fix the contact between the lens guard210 and the scope, the manifold cap 2400 serves to fix the cam grip 220relative to the body of the lens guard 210 so as to prevent its rotationaround the axis shared by the scope and the lens guard 210. Thus, theupper surface of the manifold cap 2400 includes means for engagementwith the collet 2210 so as to prevent its axial rotation. In theembodiment depicted in FIGS. 17A and 17B, the manifold cap 2400 includesa plurality tabs 2410, in this case three, that engage with slots 2216formed between adjacent collet lobes 2212. The tabs 2410 serve toprevent axial rotation of the collet 2212 and also serve to limit theextent to which the collet 2212 is compressed when in use, as furtherdescribed herein. The manifold cap 2400 includes engagement means on itslower surface (see FIG. 178A for engagement with and positional fixationrelative to the manifold 900.)

Referring again to FIG. 17B, as depicted, the cam grip 2200 includes aplurality, in this case three, collet lobes 2212 that are attached toform the substantially ring-shaped collet 2210, the collet lobes 2212are connected by three living hinges 2214. Each collet lobe 2212 isattached to an adjacent collet lobe 2212 via a living hinge 2214attachment means. As depicted, the collet lobes 2212 have a generallycrescent-shaped profile and when interconnected form an internal channelthat is substantially cylindrical and an outer surface that iscontoured. And as depicted, the living hinges 2214 have a generally “U”shaped profile. The collet lobes 2212 and hinges 2214 may be shapeddifferently. It will be appreciated that the number of collet lobes 2212and the number of living hinges 2214 may vary, and that in someembodiments there may be as few as two collet lobes 2210 and two livinghinges 2214, and in other embodiments a greater number of each may beused, and that they may vary in size, shape and spacing.

As will be further described herein, the assembled collet 2210 isactuated by interaction with the locking knob 2000, which has areceiving means that interferes with the collet lobes 2212 when thelocking knob 2000 and the cam grip 2200 are engaged so as to compressthe collet lobes 2212, which in turn flexes the living hinges 2214,causing the adjacent collet lobes 2210 to move towards one another andto translate radially inward toward the center of the channel such thatthe circumference of the substantially circular channel through thecollet is reduced. Engagement between the tabs 2410 on the manifold cap2400 and the collet 2212 limit the extent to which the collet 2210 iscompressed. Thus, actuation of the cam lobes 2212 leads to flexion ofthe living hinges 2214 and reduction of the diameter of the centralchannel, which serves to compress the grommet 2250, which thereby gripsa scope body that it is inserted therethrough. FIG. 17C shows the camgrip 2200 and manifold cap 2400 in association with a surgical scopewith the grommet 2250 axially displaced from the collet 2210 toillustrate the relative positioning of the collet 2210 componentsrelative to the scope.

According to the device embodiment depicted in FIGS. 16, and 17A-17C,the collet 2210 components are of unitary construction and eachcomponent is formed of the same materials. The materials of constructionmay be selected from plastics or other composite materials describedwith respect to other components of the devices disclosed herein. Ofcourse, in other embodiments, the collet 2210 components may be formedas a plurality of pieces that are connected using one or moreappropriate means know in the art, such as by snap fit, sonic welding,glue or other adhesive, or other means Likewise, the collet 2210components may each be formed of different materials. For example, theliving hinge 2214 components may be formed of a less rigid and moreflexible material as compared with the material of the collet lobes2212. Thus, in some alternate embodiments the collet 2210 may be ofunitary construction but comprise different materials for varioussubcomponents, and the construction may be achieved by various knownmethods such as in the molding and injection molding arts. And in otherembodiments, the components may be discretely manufactured of the sameor different materials having the same or varying properties.

Referring again to FIG. 17B, the grommet 2250 is formed as a cylindersized to fit within the circular channel through the collet 2210. Insome embodiments the grommet 2250 may be formed of the same material asone or more of the collet 2210 parts. In some embodiments the grommet2250 is formed of a flexible rubber or other elastomeric material. Asdescribed above, the grommet 2250 functions to enhance the contactbetween the collet 2210 and the scope. In some embodiments, the grommet2250 includes one or more channels that are parallel to the channel andare formed on the inner face of the grommet 2250. As depicted, thegrommet 2250 has a plurality of channels, in this case three, that arearrayed at equally spaced intervals on the inner surface of the grommet2250. The purpose of the channels is to provide a buckling or hingepoint for the grommet 2250 to collapse as it is radially compressed byactuation of the collet 2210.

Referring now to FIGS. 18A-18C, various views and configurations of thelocking knob 2000 and the cam grip 2200 are shown. FIG. 18A shows alower perspective view of the locking knob 2000 and the cam grip 2200engaged with the manifold cap 2400, detailing the features of theunderside of the manifold cap 2400 that are engageable with the manifold900, and the features on the underside of the locking knob 2000. FIG.18B shows a top perspective view of the locking knob 2000 and the camgrip 2200 engaged with the manifold cap 2400, detailing the features ofthe grip portion of the locking knob 2000 and the components of the camgrip 2200. As previously described, the locking knob 2000 engages withthe collet 2210 to compress the cam grip 2200 and thus grip the lensguard 210 to the surgical scope. Referring to FIG. 18A, the underside ofthe locking knob 2000 includes a cam engagement cavity 2020 that iscontoured so as to interfere with the collet lobes 2212. Thus. when thelocking knob 2000 is advanced along the length of the scope body intocontact with the cam grip 2200 the collet lobes 2212 are radiallydisplaced inwardly to effectively close the collet channel against thegrommet 2250 and thereby grip the scope. Referring again to FIG. 18A,the rim of the cam engagement 2020 cavity of the locking knob 2000includes snap tabs 2040 that project radially into the cavity and arearrayed to engage with the manifold cap 2400 which is in turn coupledwith the manifold 900. FIG. 18C shows the cam grip 2200 engaged with thelocking knob 2000.

Referring now to FIGS. 19A, 19B and 19C, these figures depictembodiments of the lens guard 210 manifold 900 that interfaces on itsupper surface with the manifold cap 2400 and receives and distributesthe flow of fluids from external sources through the lens guard 210 andto its tip. The device components shown in these various figures providethe same functionalities as described in connection with alternateunitary construction devices, namely delivery of continuous orintermittent fluid flow at the distal end of a surgical scope, venting,and delivery of user actuated liquid and gas flow. The flow controllerand lens guard components according to these illustrated and picturedembodiments are connected via one or more fluid flow conduits, asillustrated in the drawings, with engagement between the flow controllerand lens guard achieved using tubing connections to the flow manifold900 on the lens guard. The manifold is adapted to receive fluid flowfrom one or more of liquid and gas sources that are interconnected withthe flow controller through tubing and in fluid connection withactuators on the flow controller.

Function of the View Optimizer

As mentioned previously, the gas/liquid actuator/regulator 250 of theillustrated embodiment is biased towards the gas flow state and deliversa generally continuous flow of gas from the insufflator when in thisstate. Accordingly, when the view optimizer 200 of the illustratedembodiment is in the normal operation state, a generally continuous flowof gas is directed across the face of the objective lens of thelaparoscope 100 through passageways 528, 530 of the end ring 308. As setforth above, this gas flows in a path that is generally parallel to theobjective lens of the laparoscope.

This generally continuous flow of gas across the face of the objectivelens of the laparoscope 100 serves to prevent the objective lens fromfogging, particularly under circumstances when there is a significanttemperature and/or humidity differential between the operating roomenvironment and the body cavity of the patient. The generally continuousflow of gas across the objective lens of the laparoscope also serves todeflect away from the objective lens any blood, bodily fluids, pieces oftissue, fat or other bodily material that may be encountered by theobjective lens of the laparoscope 100 during an operative procedure. Ifblood, bodily fluids, pieces of tissue, fat or other bodily material iscontacted by and sticks to the objective lens of the laparoscope 100,the gas flow from passageways 528, 530 serves to remove the materialfrom the objective lens of the laparoscope 100 and to prevent thematerial from obstructing the view of the surgeon or medical technicianthrough the scope.

The view optimizer 200 of the illustrated embodiment is adapted for usewith conventional insufflators that typically provide gas at a flow rateof between zero (0) and fifteen (15) liters per minute when cyclingduring normal operation. Of course, other insufflators may deliver gasat flow rates that are considerably higher or lower, and may still beuseful with the view optimizers disclosed herein. Thus, the viewoptimizer 200 of this detailed description can be adapted to be usedwith insufflators having a variety of flow rates. When in the gas flowstate during normal operation, the view optimizer 200 of the illustratedembodiment is adapted to divert approximately 9% to 18% of this gasprovided from the insufflator for delivery to the objective lens of thelaparoscope 100 through the lens guard 210. Accordingly, the remainderof the gas provided by the insufflator continues to be delivered to thepatient's body cavity through one or more of the trocars and not passthrough the view optimizer 200. For example, if the insufflator produces1 liter per minute (L/min), then 0.1 L/min (10%) would go through theview optimizer 200 to the patient and 0.9 L/min would go through theinsufflator trocar to the patient Additional embodiments of the viewoptimizer 200 may divert more or less of the flow from the insufflatorto the view optimizer 200. Accordingly, in various embodiments, the viewoptimizer 200 may divert about 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, or18,% of the gas provided from the insufflator. However it should beunderstood that additional embodiments of the view optimizer 200 maydivert gas from the insufflator in excess of 19, 20, 25, 30, 40, 50, 60,70, 80, 90% or more. And it will be appreciated that in yet otherembodiments, the source of the gas may be from other than theinsufflator, in which case there is no diversion of gas from directdelivery to the patient's body cavity.

When in the gas flow state during normal operation, the view optimizer200 of the illustrated embodiment delivers a generally continuous flowof gas across the objective lens of the laparoscope 100 at a flow ratebetween zero (0) and ten (10) liters per minute. In some embodiments,the view optimizer 200 delivers a flow of gas at a flow rate between0.01 and five (5) liters per minute, and in yet other embodiments theview optimizer 200 delivers a flow of gas at a flow rate between two anda half (2.5) and five (5) liters per minute. This generally continuousflow of gas across the objective lens of the laparoscope 100 forms a gas“screen,” or “shield.” This gas “screen” or “shield” of continuous gasflow across the objective lens of the laparoscope 100 is delivered at avelocity of between zero (0) and about forty (40) meters per second. Insome embodiments, the velocity of gas is from about nineteen (19) tothirty eight (38) meters per second. Accordingly, in variousembodiments, the flow rate of the gas across the lens is about 0, 0.01,00.2, 0.03, 0.04, 0.05, 0.06, 0.07, 0.08, 0.09, 0.1, 0.2, 0.3, 0.4, 0.5,0.6, 0.7, 0.8, 0.9, 1.0, 1.1, 1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.8, 1.9,2.0, 2.1, 2.2, 2.3, 2.4, 2.5, 3, 4, 5, 6, 7, 8, 9 or 10 L/min, orincrements thereof. And the velocity of the gas screen is about 1, 2, 3,4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17 18, 19, 20, 21, 22, 23,24, or 25 m/s. However it should be understood that additionalembodiments of the view optimizer 200 may deliver gas to the objectivelens of the laparoscope at a variety of different flow rates andvelocities, in which case such flow rates may exceed 10 L/min or greaterand the velocities may exceed 25, 30, 40, 50, 60, 70, 80, 90 or 100 m/sor greater.

During a surgical procedure, blood, bodily fluids, pieces of tissue, fator other bodily material may become lodged upon the objective lens ofthe laparoscope and effectively resist deflection or removal by the gasflow provided by the view optimizer in normal operation state. To helpfacilitate the removal of such adherent material, the view optimizer 200of the illustrated embodiment provides a burst flow feature. An operatormay activate the burst flow feature of the illustrated embodiment of theview optimizer 200 through the use of the burst actuator/regulator 260.As mentioned previously, the burst actuator/regulator 260 of theillustrated embodiment is a manually operated, pneumatic bulb. Toactivate the burst flow feature of the illustrated embodiment of theview optimizer 200, an operator squeezed the pneumatic bulb of the burstactuator/regulator 260. When the burst actuator/regulator 260 isactivated, the view optimizer 200 of the illustrated embodiment deliversa burst or bolus of gas from the insufflator to the objective lens ofthe laparoscope 100. During the burst flow state, the view optimizer 200of the illustrated embodiment delivers a burst or bolus of gas at a flowrate between zero (0) and twenty (20) liters per minute at a velocity ofbetween zero (0) and one hundred and forty five (145) meters per second.Accordingly, in various embodiments, the gas burst flow rate of the gasacross the lens is about 0, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13,14, 15, 16, 17, 18, 19, and 20 L/min, or increments thereof. And thevelocity of the gas burst flow is about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10,11, 12, 13, 14, 15, 16, 17 18, 19, 20, 25, 30, 35, 40, 45, 50, 55, 60,65, 70, 75, 80, 85, 90, 95, 100, 115, 130, or 145 m/s, or incrementsthereof. However it should be understood that additional embodiments ofthe view optimizer 200 may deliver gas burst flow to the objective lensof the laparoscope at a variety of different flow rates and velocities,in which case such flow rates may exceed 20, 25, 30, 35, 40, 45, 50L/min or greater and such velocities may exceed 150, 155, 160, 165, 170m/s or greater. The burst or bolus of gas serves to remove blood, bodilyfluids, pieces of tissue, fat or other bodily material lodged upon theobjective lens of the laparoscope that is resistant to the gas flowprovided by the view optimizer in the normal operation state.

As mentioned previously, when the gas/liquid actuator/regulator 250 ofthe view optimizer 200 of the illustrated embodiment is in the liquidflow state, liquid is delivered to the objective lens of the laparoscope100 and the delivery of gas ceases. When the gas/liquidactuator/regulator 250 is in the liquid flow state, liquid flows fromthe liquid source into the liquid inlet 240 of the flow controller 220,through the gas/liquid actuator/regulator 250, through a piece or seriesof tubing into a fluid connector 313 of the connector plate 310, throughopening 642 of the adapter ring 302, through a channel 630 of theadapter ring 302, through a corresponding channel 512 of the guard tube304, through channel 518 of the exhaust ring 306, and is directed acrossthe lens of the laparoscope 100 by passageway 526 of the end ring 308.Accordingly, when the view optimizer 200 of the illustrated embodimentis in the liquid flow state, a generally continuous flow of liquid isdirected across the face of the objective lens of the laparoscope 100through passageway 526 in a path that is generally parallel to theobjective lens. As shown in FIG. 4C, the passageway 526 of the end ring308 that delivers the fluid to the objective lens is located in aposition which directs the flow of the liquid in a path which isgenerally perpendicular to the flow of the gas provided by channels 528,530 of the end ring 308. However, it should be understood that the viewoptimizer 200 of the illustrated embodiment is not limited to thisconfiguration of the flow of liquid and gas and additional embodimentsof the view optimizer 200 may provide a different configuration of gasand/or liquid flow. In addition, the gas and/or liquid flow ofadditional embodiments of the view optimizer may be angled towards oraway from the objective lens of the laparoscope 100.

When the gas/liquid actuator is in the liquid flow state, the viewoptimizer 200 of the illustrated embodiment delivers liquid at a volumeof generally between zero (0) and 0.4 liters per minute at a velocity ofgenerally between zero (0) to 0.0075 meters per second. However, itshould be understood that additional embodiments of the view optimizer200 may deliver liquid at various other flow rate and velocities.Accordingly, in various embodiments, the flow rate of the liquid acrossthe lens is about 0, 0.1, 0.2, 0.3, or 0.4 L/min. And the velocity ofthe liquid flow is about 0 to about 0.0075 m/s. However it should beunderstood that additional embodiments of the view optimizer 200 maydeliver liquid to the objective lens of the laparoscope at a variety ofdifferent flow rates and velocities, in which case such flow rates mayexceed 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1.0 or greater and such velocitiesmay exceed 0.0075 m/s or greater. This delivery of liquid to theobjective lens of the laparoscope 100 serves to defog or clean theobjective lens.

The burst actuator/regulator 260 of the additional embodiments of theview optimizer 200 may be adapted to serve as a gas accumulator (notshown) that accumulates pressurized gas from the insufflator, or fromone or more other or additional gas sources. In the event that theinsufflator cycles into the static, non insufflating state, the gaswithin the gas accumulator of such additional embodiments is deliveredto the objective lens of the laparoscope via the view optimizer 200.This delivery of gas from the gas accumulator ensures that the viewoptimizer 200 is supplied with a generally steady supply of gas evenwhen the insufflator cycles into the static state. In this manner, thegas accumulator would act as a damping mechanism to smooth out thecyclic on/off of the insufflator and ensure that a generally steady,continuous flow of gas is delivered to the objective lens of thelaparoscope 100.

As an example, the burst actuator/regulator 260 of some additionalembodiments may be an elastic, compliant chamber that expands toaccumulate gas from the insufflator. In this manner, the burstactuator/regulator 260 could be used to actuate the delivery of a burstor bolus of gas and or liquid to the objective lens as well as servingas a gas accumulator. A backflow valve may be provided with such burstactuators 260 of additional embodiments to prevent gas from returning tothe insufflator from the burst actuator/regulator 260. Such gasaccumulators are adapted to accumulate gas from the insufflator until apredetermined, threshold pressure of gas within the gas accumulator isreached. Once the threshold pressure is reached, the gas accumulatorwould not accumulate any additional gas from the insufflator. Thisthreshold pressure could be maintained within the accumulator either bythe use of a valve or similar control mechanism or simply be maintainedby the pressure of the flow of gas supplied by the insufflator.

The gas accumulator of such embodiments is adapted to maintain apressure that is equal to or greater than the predetermined pressure atwhich the patient's body cavity is desired to be maintained. Once thepressure within the patient's body cavity drops below the predeterminedpressure, due to the cycling off of the insufflator or some otherreason, the gas accumulator would deliver gas to the objective lens ofthe laparoscope 100, thereby, also delivering gas to the patient's bodycavity. In instances where an elastic, compliant chamber is supplied asthe gas accumulator, the chamber will elastically contract in responseto a pressure differential between the gas accumulator and the patient'sbody cavity. This contraction of the gas accumulator would serve todeliver gas to the objective lens of the laparoscope 100 and thepatient's body cavity. The delivery of gas by such a gas accumulatorcould be controlled by the utilization of a valve or similar controlmechanism. The delivery of such gas could also be delivered in a mannerthat is not capable of being controlled by the user.

It should be understood that the gas accumulator described above couldbe provided as a single chamber or multiple chambers. The gasaccumulator could be incorporated with the burst actuator/regulator 260as described above or could be provided separately from the burstactuator/regulator 260. In embodiments in which the burstactuator/regulator 260 and the accumulator function are providedseparately from one another, they could each be connected to theinsufflator in series or in parallel with respect to one another. Onceall or a portion of the gas contained within the gas accumulator hasbeen delivered to the objective lens of the laparoscope, the gasaccumulator must be refilled with gas. If the gas accumulator isconnected in series with the burst actuator/regulator 260, or othercomponent of the view optimizer 200 that delivers gas to the objectivelens, all or a portion of the flow of gas from the insufflator willfirst fill the gas accumulator to capacity prior to being delivered tothe objective lens of the laparoscope. Due to this phenomenon, adecreased amount of flow will be delivered to the objective lens duringthe filling of the gas accumulator. Upon the initial startup of theinsufflator or the cycling of the insufflator to an insufflation statefrom a static state, this can result in a time period during whichlittle or no gas is delivered to the objective lens of the laparoscopeduring the filling of the gas accumulator. To prevent this fromoccurring, in some embodiments of the view optimizer, the gasaccumulator is connected to the insufflator in parallel with relation tothe burst actuator/regulator 260 or other components of the viewoptimizer 200 that deliver gas to the objective lens of the laparoscopeto ensure that an effective flow of gas to the objective lens ismaintained while the gas accumulator is being filled. In suchembodiments, a portion of the gas from the insufflator can be divertedto refill the accumulator only if this diverted flow will not cause theflow of gas that is being delivered to the objective lens to drop belowan effective amount. In various embodiments, the flow being diverted tothe accumulator can be controlled by a valve or other similar controlmeans.

It should be understood that the gas accumulator of additionalembodiments could be adapted to accommodate a variety of differentvolumes of pressurized gas. In yet additional embodiments, the gasaccumulator could be a non-compliant chamber that is activated by acontrol switch or other actuation means to deliver gas to the objectivelens of the laparoscope 100 when the insufflator ceases insufflating.Such a gas accumulator could be electronically controlled and connectedto the insufflator via electronic circuitry so as to be responsive tothe cycling of the insufflator. Finally, it should be understood thatadditional embodiments of the view optimizer 200 may not be suppliedwith gas from an insufflator, but, rather, may include a gas supplyingdevice incorporated within the view optimizer 200 that is comparable tothe insufflator.

According to some embodiments, vibration of the objective lens of thelaparoscope is utilized as an additional means for removing moisture anddebris from the objective lens and/or preventing moisture and debrisfrom adhering to the objective lens. According to some such embodiments,the view optimizer 200 is adapted to utilize the flow of gas from theinsufflator to vibrate the objective lens. For example, the end ring 308is structured in such embodiments in such a way that the flow of gasover or through the end ring 308 vibrates the end ring 308 and, thus,vibrate the objective lens as well. One such embodiment includes an endring 308 including flexible flaps that are adapted to vibrate the endring 308 as gas from the insufflator flows over the flaps. Additionalembodiments of the view optimizer 200 include mechanical means forvibrating the objective lens that do not utilize the flow of gas fromthe insufflator. For example, some embodiments utilize a piezoelectricend ring 308 or one or more eccentric weights to vibrate the objectivelens. It should be understood that in additional embodiments of the viewoptimizer 200, vibration of the objective lens may be provided incombination with one or more of the cleaning and/or defogging methodspreviously described or may be provided alone.

The leak of the illustrated embodiment is created by a vent or ventsdefined within the lens guard 210. The leak of the illustratedembodiment of the view optimizer 200 is a controlled leak that can becontrolled by a user of the scope through the use of a valve or othercontrol mechanism. The valve provided to control the leak could be asimple two-state, on/off valve or it could be a multi-state, variablevalve that allows the flow rate of the leak to be adjusted. The valve orother control mechanism could be either manually operated or automated,or under electronic control. Thus, it should be understood that the leakcreated by the view optimizer 200 could provided in a manner that is notcontrolled by a user.

The view optimizer 200 of the illustrated embodiment provides a leakthat has a flow rate that is generally between zero (0) and eight (8)liters per minute, and approximately 7.8 liters per minute, wherein twoof the six channels are for exhaust venting (as discussed further hereinin connection with FIG. 4. Accordingly, in various embodiments, the flowrate of the leak is about 0, 0.5, 1, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 4.5,5.0, 5.5, 6.0, 6.5, 7.0, 7.5, 8.0 liters per minute. However it shouldbe understood that additional embodiments of the view optimizer 200 mayprovide a leak having a variety of different flow rates, in which casesuch flow rates may exceed 8, 9, 10, 12, 14, 16, 18, or more liters perminute, or increments thereof. As a way of illustrating the effect ofthe leak provided by the view optimizer 200 of the illustratedembodiment on the insufflator, the following information was collectedregarding the cycling intervals of a conventional insufflator during anoperative procedure when a leak was provided by the view optimizer ascompared to the insufflator operating without a leak being provided.

In addition, while the leak created by the view optimizer 200 of theillustrated embodiment is a passive leak that relies on the pressurewithin the patient's body cavity to expel gas from within the cavity,alternative embodiments of the view optimizer could be augmented by theutilization of a vacuum or other suction means to create a suction forcethat actively draws gas out from within the patient's body cavity. Insuch embodiments, the leak could likewise be under the control of theuser, or otherwise under the control of an automated source or anelectronic control.

Such embodiments that provide a vacuum or other suction means, mayprovide a suction force between zero (0) inches of mercury (in. Hg) andtwenty six (26) inches of mercury (in. Hg). Accordingly, in variousembodiments, the suction force provided is about 0, 1, 2, 3, 4, 5, 6, 7,8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25 or26 inches of mercury (in. Hg). In some embodiments the suction forceprovided by the vacuum or other suction means of such embodiments isbetween twelve (12) inches of mercury (in. Hg) and fourteen (14) inchesof mercury (in. Hg). However it should be understood that additionalembodiments of the view optimizer 200 may provide a suction force havinga variety of values that exceed 26 inches of mercury.

In additional embodiments of the view optimizer 200, the controlled leakcould be created in alternative ways other than vents defined within thelens guard 210. For example, the leak could be created by a vent definedwithin the interface between the view optimizer 200 and the trocar thatreceives the view optimizer 200. For instance, the outer diameter of thelens guard 210 could be adapted to create a gap between the outerdiameter of the lens guard 210 and the inner diameter of the trocaropening, thus, creating a leak. In addition, one or more notches,indentations or other openings could be defined within the portion ofthe view optimizer 200 that interfaces with the trocar, or,alternatively, within a portion of the trocar that interfaces with theview optimizer 200, to create a gap through which gas could escape.Additional embodiments may include one or more notches, indentations oropenings that extend along the entire length of the lens guard 210,thereby, creating a leak between the lens guard 210 and the trocar. Asdiscussed previously, it should be understood that this leak located atthe interface between the view optimizer 200 or lens guard 210 and thetrocar could be controlled with the use of a valve or other controlmechanism. Thus, in one example, referring to FIG. 1B, the leak may beachieved using the stopcock valve 810 of a conventional trocar, wherebyan operator opens or “cracks” the vacuum within the surgical system byactuating the valve. In addition, this leak could be a passive leak orcould utilize a vacuum or other pumping means to actively draw gas outfrom within the patient's body cavity. It will be appreciated that theconstruction of the lens guard 200 may be adapted such that whether itis formed as continuous sheath, or is formed of two or more portions, itis nevertheless adapted to allow for the introduction and control of aleak according to the various embodiments described herein, whetherrelying on conventional venting means in the trocar system, or otherstructures or features of the trocar or the inventive devices herein.

While the creation of a leak helps to ensure that the insufflatorprovides the view optimizer 200 with a generally continuous supply ofgas, the leak can also serve to remove moisture from within thepatient's body cavity, thereby, decreasing the humidity within thecavity. Humidity levels in a laparoscopic surgical field can range frombelow 50% to close to 100% relative humidity; in most cases, the rangeis from about 75% to 99%, and most typically from about 85% to about95%. Thus, the humidity within the abdomen can exist from less than 50%,to 55, 60, 65, 70, 75, 80, 85, 90, 95 and 100%, and increments thereof.Reduction of the humidity within the patient's body cavity serves todiminish the likelihood that the objective lens of the laparoscope 100will become fogged when it is within the patient's body cavity. Inaddition, the leak can also help to remove smoke and mist generated fromthe use of a harmonic scalpel, and/or other particulate matter that issuspended in the gas within the patient's body cavity. This removal ofairborne matter from within the patient's body cavity serves to ensurethat the visibility through the objective lens of the laparoscope 100 ismaintained.

It should be understood that the gas exiting the patient's body cavityvia the leak created by the view optimizer 200 could be filtered invarious embodiments. This filtering process could serve to remove blood,bodily fluids, or other matter from the gas exiting the patients bodycavity, thus, preventing these potential contaminants from entering theair within the operating room. It is beneficial to remove such matterfrom the escaping gas to prevent anyone in the operating room frominhaling such matter. It should also be understood that the gas exitingthe patient's body cavity via the leak could be recycled for re-deliveryinto the patient's body cavity by the insufflator or the view optimizer200. In addition, baffles or other muffling means could be incorporatedwith the vents provided by additional embodiments to muffle the sound ofgas exiting the vents. Finally, it will be understood that in otherembodiments, wherein the supply of fluid is to be intermittent, thatthere is not a need for a leak.

EXAMPLES Example 1 Effect of Venting and Incidence of Scope Removal

Evaluation of effect of venting on insufflator function was evaluatedduring a laparoscopic surgical procedure. The ambient surgical roomtemperature was 67° F., the temperature of the carbon dioxide supply was60 F, and the room humidity was 74%. The following general observationsof insufflator function were recorded: after establishing constantpressure in the abdomen sufficient to shut off insufflator operation,followed by a sudden pressure drop in the surgical cavity, there was a2-3 sec lag before the insufflator restarted. During the standardlaparoscopic procedure, the insufflator was in inflation mode ˜60% oftime, and cycled off for a maximum time of about 11 sec.

During a hand assisted laparoscopic procedure, the insufflator was ininflation mode ˜75% of time, and cycled off for a maximum time of about5 sec. During the standard laparoscopic procedure, with a slowcontinuous leak at the stop cock, with the insufflator set at a flow of5-6 liters per minute and 12-13 mm HG, the insufflator remained ininflation mode 100% of time. During the standard laparoscopic procedure,with a slow continuous leak through a 16 G angiocath, with theinsufflator set at a flow of 5 liters per minute and 12-17 mm HG, theinsufflator remained in inflation mode 100% of time.

During the standard surgical procedure, without hand assist, the scopewas removed from the patient several times, for the reasons anddurations as follows: Fog 40 sec; Fog 40 sec; Blood 40 sec; Fog 30 sec;Cautery 25 sec; Cautery 30 sec; Fog 30 sec; and Fog 25 sec. During thestandard surgical procedure, with hand assist, the scope was removedfrom the patient several times, for the reasons and durations asfollows: Fog 30 sec; Fog 60 sec; Cautery 25 sec; Cautery 25 sec; Debris25 sec; Fog 60 sec; Fog 45 sec; Fog 30 sec; and Fog 30 sec.

Example 2 Evaluation of Fogging

In a device that simulates the humidity and temperature conditions of ananimal abdominal cavity during a laparoscopic procedure, the effects offogging on a laparoscopic lens was evaluated. Chamber temperature of99.4-99.7° F., and an initial scope lens temperature of 70.1-72.1° F.,humidity was 75-77% RH. FIG. 8 shows the change in scope temperature atthe lens and various locations along its length at various times at thechambers humidity.

Relative humidity is understood as the Ratio of water vapor (dew point).Above the line corresponding to the relative humidity in the chamber, nocondensation is observed; below the line, condensation is observed. Theprinciple was observed in the study, wherein, upon initial insertion ofthe scope into the chamber, fogging immediately occurred andvisualization of an object in the chamber was obscured. It was observedthat visualization of the object improved as the scope heated up abovedew point temperature, and condensation dissipated.

Example 3 Evaluation of Accumulator Reservoir Function

Testing was performed in a simulator as described in EXAMPLE 2 tocompare insufflator function with and with out an accumulator. Theconditions of testing were similar for each trial, with chambertemperature of 99.4-99.7° F., and an initial scope lens temperature of70.1-72.1° F., humidity was 75-77% RH.

The defogging threshold was determined in later testing. A valve wasplaced inline with an embodiment of the view optimizer described hereinand attached to a compliant reservoir. This valve was slowly closeduntil the airflow was restricted to the point where de-fogging did notoccur. Two trials were performed with the chamber temperature being102.9-103.9° F. with an initial scope lens temperature of 70.5-70.9° F.,humidity was 75-76% RH. Observation of the data recorder showed that atsteady state, the maximum peak flow was registered at 1.3V during thistime. The voltage of the sensor at 0 flow was measured pretest at1.228V. FIG. 8 shows the resulting data, wherein the use of anaccumulator reservoir compensated for the insufflator to deliver acontinuous stream of air when the insufflator was shut-off, and a shiftin flow was observed upon re-initiation of insufflator function untilthe complaint reservoir was replenished with gas.

Example 4 Use of the View Optimizer

SET UP. In use, the view optimizer is removed from packaging (example ofone embodiment of packaged device is shown in FIG. 12, and as removedfrom the package as shown in FIG. 13).

Referring now to FIG. 14, the view optimizer is uncoiled for connectionto the systems in the operating suite. The sequence of the followingsteps 2-6 may be modified to suit operating room practice.

Spike the view optimizer's Saline Line which is tagged & labeled (seeFIG. 14) into the port of a pressurized irrigation bag. Insure that aproper connection is made and that no leaks are visible. If desired,spike the water line of a suction/irrigation system into the viewoptimizer's Auxiliary Irrigation Port provided via the Y-connector (seeFIG. 14). If connection cannot be made, use an additional irrigationbag. Connect the view optimizer's Insufflator Line which is tagged &labeled (see FIG. 14) to the insufflator output or to the line thatwould formerly have been connected to the stopcock on the insufflationtrocar. The Insufflator Line comes with an attached luer connector. Thiscan be removed to accommodate a different style connection if desired.Connect the view optimizer's Trocar Line (tagged & labeled) to thestopcock on the insufflation trocar once the trocar has been properlyintroduced through the abdominal wall. It is recommended that theoptical trocar NOT be used as the insufflation trocar. (Note: The TrocarLine remains on the sterile field after the connection is made.) Clipthe view optimizer's Rinse Pistol assembly (also referred to as flowcontroller) to an accessible place on the sterile field of the surgicaltable. Use the attached Pistol Clamp (see FIG. 14) to properly secure itto the surgical drape to prevent it from inadvertently falling off thesterile field. The Rinse Pistol only needs to be accessed when a salineflush to the laparoscopic lens is needed. There is no need to constantlygrasp or otherwise tend to the Rinse Pistol throughout the course ofsurgery.

While gently pressing the Tip of the view optimizer's Sheath assembly(also referred to as lens guard) against one hand or finger-tip,carefully insert the laparoscope down into the Sheath until the lens anddistal rim of the scope is seated on the back of the view optimizer'sTip. The scope will “bottom out” inside the device. Caution: Do not useexcessive force when inserting the scope into the sheath, or “slam” thelaparoscope into the back of the view optimizer's Tip. The scope shouldslide smoothly through the shaft of the device.

While holding the laparoscope fully inserted into the Sheath, andsupporting the Manifold of the Sheath by hand (see FIG. 14), rotate theLocking Collar on the Sheath assembly clockwise approximately one-third(⅓) of a turn until a firm stop is felt (see FIG. 14). This locks thescope to the view optimizer device. Note: Once locked, any rotation orup/down movement of the laparoscope inside the Sheath will not bepossible without potentially stripping the locking mechanism. Be certainto unlock the scope before attempting to rotate or otherwise move itwithin the sheath. Before locking, check to see if any part of the Tipis present in the view of the scope (as projected on the monitor). Ifso, simply rotate the shaft of the scope inside the Sheath and Manifoldassembly until the image of the Tip is eliminated. It may be considereduseful to align the view optimizer's Manifold Tubing (air & saline line,see FIG. 14) in parallel with the cord of the laparoscope's light sourcebefore locking. Use the supplied Tubing Clip to attach the tubing to thecord and maintain this alignment. Once locked into place, examine thetip end of the view optimizer and scope assembly. To ensure properfunction, the view optimizer's Tip should be securely fastened to itsSheath and no space or visible gap should be observed between the distalrim of the scope's shaft and the Tip of the device.

Operating the Device

With the insufflating trocar in place and the Trocar Line properlyconnected, switch on the insufflator to inflate the abdominal cavity asusual. Insert the scope and the attached the view optimizer Sheaththrough a 12 mm optical trocar and acquire visualization of the surgicalsite as usual. Caution: Do not use excessive force when inserting theSheath and scope assembly into the trocar. The assembly should slidesmoothly down the trocar. During the normal course of surgery, the viewoptimizer device will operate automatically to prevent fogging. Operatethe laparoscope as normal. No user intervention is required.

As intra-operative visualization may be impaired due to the adherence ofblood or surgical debris on the laparoscopic lens, depress the FlowButton (see FIG. 14) on the Rinse Pistol to activate a pressurized flowof saline across the lens. The saline flow will continue as long as theFlow Button is depressed, and will stop when the Flow Button isreleased. Typically, only a momentary flow (2-3 seconds) of saline willbe sufficient to effectively rinse the lens of the laparoscope. Multiplerinses may be necessary.

To blow off any residual saline which may be present on the lens afterrinsing, squeeze the Bulb (see FIG. 14) on the Rinse Pistol with a firm,sudden force creating an air burst. Several bursts may be required toremove all droplets of saline. Another flush of saline, followed byanother burst from the Bulb may also prove useful in the case of astubborn water droplet interfering with visualization. Due to thecontinuous laminar flow across the lens, small droplets will disappearspontaneously after a few seconds. For fatty substances, externalcleaning of the lens may sometimes be required. In this case, carefullywithdraw the scope/Sheath assembly from the trocar and clean the lenswith a wet 4×4 gauze pad. Before re-insertion, re-examine the assemblyto ensure that there is no visible gap between the end of the scope andthe Tip of the device. Excessive movement of the Rinse Pistol and/ortubing lines may cause a small droplet of saline to appear on the lenswithout depressing the Flow Button. Should this occur, squeeze the Bulbto remove this droplet.

Removal/Disassembly

At the conclusion of surgery, withdraw the scope/the view optimizerassembly from the trocar. Unlock the assembly by rotating the LockingCollar counterclockwise approximately ⅓ of a turn. Slide the laparoscopeout of the Sheath. Caution: Care should be taken not to inadvertentlydrop and damage the laparoscope once the assembly has been unlocked.Disconnect the tubing set from the insufflating trocar, the insufflatoroutput circuit, and the saline reservoir. Dispose of the entire the viewoptimizer device and ancillary tubing set. Caution: The used viewoptimizer device should be treated as bio-hazardous waste and disposalshould be in accordance with established institutional protocols.

Troubleshooting

If insufflation of the abdomen has been achieved and the laparoscopicview fogs and fails to clear within several seconds after insertion ofthe scope/the view optimizer assembly, try one or more of the following:Withdraw the scope/the view optimizer assembly from the trocar andexamine the Tip. No visible gap should exist between the Tip and thelens/distal rim of the scope. If a gap does exist, unlock the assemblyby rotating the Locking Collar counter-clockwise, pull the scope backseveral inches within the view optimizer Sheath, and reseat it byrepeating steps above. Check to make sure there are no kinks orobstructions in the CO₂ line from the insufflator to the view optimizerdevice. Add additional venting to the system by slightly opening thestopcock of an adjacent trocar so as to create an air leak. Withdraw theassembly from the trocar and wipe the lens with a clean 4×4. Ifoperation of the Rinse Pistol and depression of the Flow Button fails toproduce a flow of saline across the laparoscope's lens, try one or moreof the following: Check that the spike connection to the salinereservoir/bag is made properly. Check that there are no apparent leaksin the water circuit. Check that the tubing is not kinked or obstructed.Check that the saline reservoir/bag is adequately pressurized. Ensurethat the laparoscope's lens is properly seated behind the Tip of thedevice, per the description herein above.

If insufflation of the abdomen cannot be achieved and the insufflator isoperating properly, check to make sure there that the proper connectionhas been made between the Insufflator Line and the insufflator, thatthere are no kinks or obstructions in the CO₂ line from the insufflatorto the view optimizer device, and that the proper connection has beenmade between the Trocar Line and the insufflating trocar.

The embodiments and examples of the view optimizer 200 described hereinare representative of aspects of the invention and are provided asexamples and not an exhaustive description of implementations of anaspect of the invention. While various aspects of the view optimizer 200are described and illustrated herein as embodied in combination in theexemplary embodiments, these various aspects may be realized in manyalternative embodiments, either individually or in various combinationsand sub-combinations thereof. Unless expressly excluded herein all suchcombinations and sub-combinations are intended to be within the scope ofthe present application. Still further, while various alternativeembodiments as to the various aspects and features of the invention,such as alternative materials, structures, configurations, methods,devices, such descriptions are not intended to be a complete orexhaustive list of available alternative embodiments, whether presentlyknown or later developed. Those skilled in the art may readily adopt oneor more of the aspects, concepts or features of the invention intoadditional embodiments within the scope of the present invention even ifsuch embodiments are not expressly disclosed herein. Additionally, eventhough some features, concepts or aspects of the invention may bedescribed herein as being a preferred arrangement or method, suchdescription is not intended to suggest that such feature is required ornecessary unless expressly so stated.

1. A view optimizer for use with a surgical scope, the view optimizeradapted to be supplied with gas from an insufflator that operates toinsufflate a body cavity to a predetermined pressure and to cyclebetween an insufflating state when the pressure within the body cavityis below the predetermined pressure and a static state when the pressurewithin the body cavity is equal to or greater than the predeterminedpressure, the view optimizer comprising: a lens guard; at least onedelivery passageway defined within the lens guard that is adapted todeliver at least a portion of gas from the insufflator to an outersurface of an objective lens of the surgical scope when the viewoptimizer is assembled with the surgical scope; a gas accumulator thatis in operable communication with the at least one delivery passagewayand is adapted to store at least a portion of the gas supplied from theinsufflator, the gas accumulator being further adapted to deliver gasstored within the gas accumulator to the at least one deliverypassageway when the insufflator is in the static state so as to maintainessentially continuous flow of gas through the at least one deliverypassageway, wherein the lens guard is remote from the gas accumulatorand is in communication therewith only through one or more conduits. 2.The view optimizer according to claim 1 wherein the lens guard isadapted to deliver a stream of gas at an essentially continuous rate of0.07 liters per minute to 10 liters per minute, and at an averagevelocity from 0.01 to 30 meters per second.
 3. The view optimizeraccording to claim 1 comprising, a lens guard stabilizing means thatengages with the lens guard and one or more components of the surgicalscope and prevents rotational movement between the lens guard and thesurgical scope.
 4. The view optimizer according to claim 3 wherein thestabilizing means is engaged on an external portion of the lens guardand is adapted to be fixable thereto and to receive and retain one ormore components of the surgical scope so that engagement between thestabilizing means, the lens guard and the surgical scope componentsfixes and secures the relative positions of the lens guard and thesurgical scope so as to prevent rotational movement between them.
 5. Theview optimizer according to claim 4 wherein the stabilizing meanscomprises a blocker having at least two elongate extensions, wherein atleast one extension engages fixably with the lens guard and at least asecond extension engages with the surgical scope.
 6. The view optimizeraccording to claim 5 wherein the stabilizing means is a blocker having asubstantially fork shape with one extension that engages fixable withthe lens guard and two opposing extensions that are parallel to oneanother and are adapted to receive a portion of the surgical scope. 7.The view optimizer according to claim 3 wherein the stabilizing means isengaged on an internal portion of the lens guard and is adapted to befixable thereto and to receive and retain the cylindrical body of asurgical scope so that engagement between the stabilizing means, thelens guard and the surgical scope components fixes and secures therelative positions of the lens guard and the surgical scope so as toprevent rotational movement between them.
 8. The view optimizeraccording to claim 7 wherein the stabilizing means comprises a cam grip.9. The view optimizer according to claim 8 wherein the cam gripcomprises a flexible and compressible grommet and a collet that isactuated by a cam means to grip the grommet into close engagement withthe surgical scope body.
 10. A view optimizer for use with a surgicalscope, comprising: a lens guard engageable with a surgical scope andhaving at least a first passageway that has a proximal end and a distalend, the proximal end of the passageway connected to a source of gas,the distal end oriented to deliver gas to an outer surface of anobjective lens of the surgical scope when the view optimizer isassembled with the surgical scope, the lens guard adapted to deliver astream of gas to the outer surface of the objective lens at anessentially continuous rate of 0.07 liters per minute to 10 liters perminute, and at an average velocity from 0.01 to 30 meters per second,and a gas delivery actuator wherein the lens guard is remote from thegas delivery actuator and is in communication therewith only through oneor more conduits.
 11. The view optimizer according to claim 10comprising, a lens guard stabilizing means that engages with the lensguard and one or more components of the surgical scope and preventsrotational movement between the lens guard and the surgical scope. 12.The view optimizer according to claim 11 wherein the stabilizing meansis engaged on an external portion of the lens guard and comprises ablocker having a substantially fork shape with one extension thatengages fixable with the lens guard and two opposing extensions that areparallel to one another and are adapted to receive a portion of thesurgical scope.
 13. The view optimizer according to claim 11 wherein thestabilizing means is engaged on an internal portion of the lens guardand comprises a cam grip that comprises a flexible and compressiblegrommet and a collet that is actuated by a cam means to grip the grommetinto close engagement with the surgical scope body.
 14. A view optimizerfor use with a surgical scope, the view optimizer supplied with gas froman insufflator, the insufflator adapted to insufflate a body cavity to apredetermined pressure, the insufflator adapted to cycle between andinsufflating state when the pressure within the body cavity is below thepredetermined pressure and a static state when the pressure within thebody cavity is equal to or greater than the predetermined pressure, theview optimizer comprising: a lens guard; a first passageway, at least aportion of the first passageway defined within the lens guard, the firstpassageway having a proximal end and a distal end, the proximal endconnected to a source of gas, the distal end oriented to deliver gas toan outer surface of an objective lens of the surgical scope when theview optimizer is assembled with the surgical scope; and an exhaustpassageway, at least a portion of the exhaust passageway defined withinthe lens guard, the exhaust passageway having a distal end including atleast one vent that is open to an outer surface of the lens guard, and aproximal end connected to an exhaust valve movable between open andclosed positions; wherein when the view optimizer is inserted into abody cavity and the valve is in the open position, gas surrounding thedistal end of the exhaust passageway is permitted to enter the exhaustpassageway through the at least one vent and exit the body cavitythrough the exhaust passageway, wherein the gas exiting the body cavitythrough the exhaust passageway prevents the pressure within the bodycavity from equaling or exceeding the predetermined pressure and therebyprevents the insufflator from cycling to the static state, and a anexhaust actuator wherein the lens guard is remote from the exhaustactuator and is in communication therewith only through one or moreconduits.
 15. The view optimizer according to claim 14 comprising, alens guard stabilizing means that engages with the lens guard and one ormore components of the surgical scope and prevents rotational movementbetween the lens guard and the surgical scope.
 16. The view optimizeraccording to claim 15 wherein the stabilizing means is engaged on anexternal portion of the lens guard and comprises a blocker having asubstantially fork shape with one extension that engages fixable withthe lens guard and two opposing extensions that are parallel to oneanother and are adapted to receive a portion of the surgical scope. 17.The view optimizer according to claim 15 wherein the stabilizing meansis engaged on an internal portion of the lens guard and comprises a camgrip that comprises a flexible and compressible grommet and a colletthat is actuated by a cam means to grip the grommet into closeengagement with the surgical scope body.
 18. A view optimizer for asurgical scope, the view optimizer being supplied with gas from aninsufflator, the insufflator being adapted to insufflate a body cavityto a predetermined pressure, the insufflator being adapted to cyclebetween and insufflating state when the pressure within the body cavityis below the predetermined pressure and a static state when the pressurewithin the body cavity is equal to or greater than the predeterminedpressure, the view optimizer comprising: an exhaust passageway having adistal end including at least one vent that is open to an outer surfaceof the view optimizer, and a proximal end; wherein when the viewoptimizer is inserted into a body cavity gas surrounding the distal endof the exhaust passageway is permitted to enter the exhaust passagewaythrough the at least one vent and exit the body cavity through theexhaust passageway, wherein the gas exiting the body cavity through theexhaust passageway prevents the pressure within the body cavity fromequaling or exceeding the predetermined pressure and thereby preventsthe insufflator from cycling to the static state, and a an exhaustactuator wherein the lens guard is remote from the exhaust actuator andis in communication therewith only through one or more conduits.
 19. Theview optimizer according to claim 18 comprising, a lens guardstabilizing means that engages with the lens guard and one or morecomponents of the surgical scope and prevents rotational movementbetween the lens guard and the surgical scope.
 20. The view optimizeraccording to claim 19 wherein the stabilizing means is engaged on anexternal portion of the lens guard and comprises a blocker having asubstantially fork shape with one extension that engages fixable withthe lens guard and two opposing extensions that are parallel to oneanother and are adapted to receive a portion of the surgical scope. 21.The view optimizer according to claim 19 wherein the stabilizing meansis engaged on an internal portion of the lens guard and comprises a camgrip that comprises a flexible and compressible grommet and a colletthat is actuated by a cam means to grip the grommet into closeengagement with the surgical scope body.
 22. A view optimizer for usewith a surgical scope, the view optimizer comprising: a lens guard; atleast one fluid delivery passageway defined within the lens guard thatis adapted to deliver fluid to an outer surface of an objective lens ofthe surgical scope when the view optimizer is assembled with thesurgical scope; at least one actuator connected with the at least onefluid delivery passageway wherein the view optimizer is adapted todeliver a fluid selected from gas or liquid to an outer surface of theobjective lens at a first flow rate when the at least one actuator isnot activated and a second flow rate when the at least one actuator isactivated, the second flow rate being greater than the first flow rate;at least one exhaust passageway defined within the lens guard, whereinwhen the view optimizer is inserted into a body cavity, the at least oneexhaust passageway is adapted to permit gas to enter the at least oneexhaust passageway and exit the body cavity through the exhaustpassageway wherein the lens guard is remote from at least one of theactuators and is in communication therewith only through one or moreconduits.
 23. The view optimizer according to claim 22 comprising, alens guard stabilizing means that engages with the lens guard and one ormore components of the surgical scope and prevents rotational movementbetween the lens guard and the surgical scope.
 24. The view optimizeraccording to claim 23 wherein the stabilizing means is engaged on anexternal portion of the lens guard and comprises a blocker having asubstantially fork shape with one extension that engages fixable withthe lens guard and two opposing extensions that are parallel to oneanother and are adapted to receive a portion of the surgical scope. 25.The view optimizer according to claim 23 wherein the stabilizing meansis engaged on an internal portion of the lens guard and comprises a camgrip that comprises a flexible and compressible grommet and a colletthat is actuated by a cam means to grip the grommet into closeengagement with the surgical scope body.